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Inducing after 24 hours "against recommendations", baby inquest told

Inducing after 24 hours

Thursday 11 April 2024

Inducing after 24 hours "against recommendations", baby inquest told

Thursday 11 April 2024


Telling a mother that it was safe to wait for 96 hours after her waters broke before inducing her "was not acceptable then and is not acceptable now", an inquest into the death of a baby girl who passed away just 33 days after being born has heard.

The claim came from one of two UK-based experts giving evidence on the third day of the inquest into the death of Amelia Amber Sweetpea Clyde-Smith.

Amelia was born in Jersey's General Hospital in August 2018 and was flown for emergency treatment to Portsmouth.

This was investigated at the time by the Royal College of Obstetricians and Gynaecologists, which found there had been “missed opportunities”, prompting an apology from senior health officials, who admitted her death was “probably” avoidable to parents Dominic and Ewelina Clyde-Smith.

The inquest, which began on Monday 8 April and is due to last until Friday 12 April, previously heard that Mrs Clyde-Smith’s pregnancy had progressed well until her waters broke around two weeks before her due date, after which she came to the Hospital with her husband, Dominic. Her time in hospital was described by one midwife on the first day of the inquest as "distressing".

On the second day, midwives spoke of a "tense" atmosphere and "culture issues" on the ward.

"Falsely reassuring"

Yesterday, the inquest heard that after Mrs Clyde-Smith’s waters broke she was given a leaflet explaining that there was little risk of infection and she could wait 96 hours before the pregnancy might need to be induced.

But consultant obstetrician and gynaecologist Dr Reeba Oliver said the risk of infection had begun to increase earlier and that medical thinking was that a pregnancy should be induced within 24 hours.

She said: “The paper that a patient takes home with them is very important and it clearly stated that it was safe for another 96 hours. It was a falsely reassuring statement.

“Waiting until after the weekend was not acceptable then and is not acceptable now. That was false reassurance.”

"If you leave it until after 24 hours, you are going against the recommendations"

Prof Kevin Dalton, another consultant obstetrician and gynaecologist, added that guidance from the UK’s National Institute for Health and Care Excellence and from other countries advised against delaying longer than 24 hours.

He said: “There’s nothing magic about 24 hours but the risk of infection slowly increases, day by day.

“Most women want to start labour naturally. But if you leave it until after 24 hours, you are going against the recommendations.

“Delaying it to 72 hours, 96 hours or whatever is against all the guidelines.”

Heart rate monitoring issue

Failures to monitor the baby’s heart rate meant hospital staff were less likely to detect abnormalities, Dr Oliver also said.

Dr Oliver explained that the baby’s heart rate had not always been monitored by cardiotography, the equipment used to monitor the foetal heartbeat during pregnancy.

She said: “You cannot make a plan for labour with a degree of loss of contact on CTG. Some effort should have been made on that.”

The inquest is being heard by coroner Bridget Dolan and is expected to conclude tomorrow.

READ MORE...

Day 1: Midwife asked not to mention incident the night before, baby inquest told

Day 2: Midwives tell baby inquest of "tense" atmosphere and "culture issues"

Inquest opens into death of baby girl in hospital

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