Belfast Telegraph

Ignored... heart rhythm traces that warned of distress in womb

By Paul Higgins

The trace of a baby girl's heart rhythm was at the centre of an emotional three-day inquest into the death of little Alexis Hook.

Coroner John Leckey had earlier heard that baby Alexis was showing signs of distress in her mother's womb almost 12 hours before she was eventually born at 1.42am.

A leading expert, Dr Paul Weir, said a trace of Alexis' heartbeat at 2pm showed four decelerations, indicating that even at that early stage "the infant was showing evidence of a precarious balance of its oxygen requirement".

He said Mrs Hook should have been monitored more closely, even just to check if it was "an isolated phenomenon".

On Tuesday, Dr Tughral Rahman said he looked at the trace at 12.25am and thought at the time it was abnormal but accepted that in hindsight, he should have classified it as "pathological".

The court heard earlier that if such a decision had been taken, Alexis would have been born within half-an-hour.

And, as Dr Weir opined yesterday, that would have given her a greater chance of life.

Dr Weir said another aspect of Mrs Hook's care which concerned him was that a junior doctor had conducted her 38-week scan and made the decision to allow her to go so far behind her scheduled due date.

He indicated that medical studies showed there was an increased risk of stillbirth with pregnancies allowed to go into their 42nd week.

Dr Weir said that had the scan and results been conducted by a consultant rather than a junior doctor, it may have been that Mrs Hook would not have been allowed to go so far overdue. This was because she was of small stature, the baby was quite big and there was evidence – contrary to the junior doctor's opinion – that the placenta was too small.

Concerning Mrs Hook's actual labour, the expert said that rather than investigate why she was experiencing increasing levels of pain, using different methods of pain relief for her frequent contractions, midwives "simply assumed that they were tightenings".

Dr Weir said that had examinations been carried out, her active labour would have been identified much earlier. This would have triggered a different approach to her care and treatment "and may have identified foetal heartbeat abnormalities much sooner".

When the family's lawyer Paddy Mullarkey asked what he would have done had he been caring for Mrs Hook, Dr Weir said he would have induced her labour three days earlier.

The expert agreed with the further suggestion that had the problems been recognised sooner, "that would have promoted the opportunity for a successful delivery of this child."

Earlier, Sinead O'Kane from the Causeway Trust, her voice shaking with emotion, told the couple: "I know it doesn't change the outcome but we have taken steps to ensure that this doesn't happen again."

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