6:00am Friday 17th May 2013
A DOCTOR broke down in tears at the inquest of a baby who died hours after a traumatic birth left her with “extensive injuries”.
Lucy McGuffin suffered fractures to her back during a “difficult birth” due to a serious condition that left her with an abdomen larger than her head, which is extremely rare.
But Southampton Coroner's Court heard that even if Lucy had been born via caesarean and avoided injury, the tragic outcome may have still been the same due to the severity of the condition, Hydrops Fetalis.
Her parents, John and Clair, who lived in Lymington at the time of the birth on August 2 last year, told the hearing that they felt there were “missed opportunities” to give their daughter a better chance of survival.
They felt that had an ultra scan been carried out on the day before the birth, the Hydrops Fetalis, which causes an abnormal amount of fluid build up in the foetus, would have been diagnosed and a caesarean would have been undertaken - as they had requested - instead of a vaginal birth which led to their daughter suffering the birthing injuries.
Mrs McGuffin, who now lives in Belgium with her husband and two other children, said: “I think there were several occasions where I think they could have and should have ultra sounded me and in that case it would have been very clear that she had a big problem in which case, that would have altered the management of the delivery.”
Mr McGuffin added: “We feel there was evidence and that it was a set of decisions and lack of resources that prevented the evidence being further investigated and we feel that is a missed opportunity.”
But doctors from the Princess Anne Hospital told the hearing that although it was recognised that Mrs McGuffin was carrying a large baby, there were no other concerns to suggest any abnormalities to justify an ultra scan or to divert from a normal delivery.
The inquest heard that it only became clear there would be complications with a vaginal birth once the baby's head had already emerged and Dr Hammed Tijani started to have difficulties easing out the rest of her body, just before 9pm.
Dr Tijani, a senior registrar who had used forceps to ease out Lucy's head but just his hands to try and ease out the rest of her body, said: “Up to the stage that the baby's head came out there was no reason to think of doing a caesarean because everything was normal.”
But as he finished giving his evidence, he broke down in tears as he asked to address Mr and Mrs McGuffin.
He added: “I am really saddened by the whole thing. I am sorry for the loss. I just pray that God continues to give you the strength to carry on. I will continue to pray for you.
“This has never happened to me before and hopefully it is the last time.”
Despite attempts to resuscitate Lucy, she died a few hours later, at 12.27am the next day.
The inquest also heard from consultant Matthew Coleman, who admitted that if they had the ability to diagnose the Hydrops Fetalis then a caesarean would have been recommended and that with hindsight the decision to have a vaginal delivery was the wrong one.
However, he added that there was no indication that there should be a problem with a normal delivery and believed enough consideration had been taken over a possible caesarean.
Speaking about the fractures Lucy sustained at birth, he said: “It is difficult to believe normal or even exaggerated obstetric manoeuvres could have resulted in such an extensive injury.
“I think there clearly was some chance she may have done much better than she did if the delivery had been different but I am still struggling to see any opportunity when we would have made difference decisions.”
He added that although a caesarean would have probably avoided such injury, a baby with severe Hydrops Fetalis has a “very different outcome to a baby born without”.
He also said that he wishes they had investigated it further but that a “lack of capacity” across the NHS means ultra scans are only undertaken when there are serious concerns about the well being of the baby or mother.
Pathologist Samantha Holden told the hearing that the post mortem revealed Lucy's death was caused by a combination of the injuries she sustained at birth, as a result of her abdominal dystocia and her underlying Hydrops Fetalis.
Coroner Keith Wiseman adjourned the inquest to consider his verdict.
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