A verdict of death by natural causes on a baby girl who survived for only two days in Dublin’s Rotunda Hospital was recorded by the Dublin District Coroner on Wednesday.
Khadiga Mohamed Elhosseiny Elsherif was delivered by emergency Caesarean section on November 14th, 2019 after doctors detected a low foetal heartbeat.
Coroner Dr Clare Keane was told the baby’s mother, Dr Samar Eltali, had been attending a routine antenatal clinic at 39 weeks and six days gestation when a routine scan showed the baby’s heartbeat was just 60 beats per minute.
Dr Eltali was taken to an emergency room where a medical assessment was made indicating an immediate Caesarean section was necessary. She was then taken to an operating theatre where an ultrasound showed the foetal heartbeat had reduced to just 30 beats per minute.
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Dr Edward Corry, specialist registrar at the Rotunda Hospital, told the coroner he had agreed with the medical team that an emergency Caesarean section should be performed.
Dr David Corcoran, consultant neonatologist, gave evidence that at five-minutes-old, Khadiga had no heartbeat. Efforts, including administering adrenaline, were made and at 15 minutes a heartbeat was detected.
However, an ECG showed little or no electrical activity in Khadiga’s brain and Dr Corcoran diagnosed severe neonatal encephalopathy – a syndrome that involves depressed or disturbed neurological function, often caused by lack of oxygen to the baby during birth.
Dr Corcoran said Khadiga did not recover and died on November 16th.
Consultant pathologist at the hospital Noel McEntagart said the cause of death was acute hypoxic ischemic encephalopathy, a type of brain damage caused by a lack of oxygen to the brain. He said this had followed a placental abruption – a separating of the placenta from the inner wall of the uterus before birth.
In a statement read to the court, Dr Etali expressed concern that she had high blood pressure and gestational diabetes and she was concerned the baby could have been delivered earlier in the pregnancy, taking these factors into account.
Giving evidence by video link, the baby’s father Mohamed Elhosseiny also claimed his wife had abnormally high blood pressure and should have been considered a high-risk patient.
However, Dr Etaoin Kent, a consultant obstetrician, gynecologist and specialist in maternal foetal medicine at the Rotunda, responded to Mr Elhosseiny, saying: “Absolutely we did assess your wife to be a high-risk patient”.
She said this was why Dr Etali was being cared for “in a consultant-led clinic”. She also told the court medical records showed Dr Eltali’s blood pressure was in the normal range.
She said a placental abruption carried “a small association with pre-gestational diabetes but not gestational diabetes”.
Dr Kent said the “vast majority [of placental abruptions] don’t have any identifiable risk factors”.
“Thankfully they are rare, but they are catastrophic”, she said.
The coroner said she was unable to resolve Mr Elhosseiny’s claims of high blood pressure readings but was satisfied with the hospital records. She expressed her sympathy to Mr Elhosseiny and his wife on their loss.
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