Baby who died two days after birth had suffered lack of oxygen

A baby boy died after he suffered a lack of oxygen to the brain shortly before birth, an inquest has heard.

Baby Stevie Cullivan was born limp and unresponsive at Midlands Regional Hospital in Mullingar at 11.59pm on April 28th, 2015.

His mother Sandra Cullivan from Longwood, Co Meath, was at the time grieving the loss of her husband Stephen Cullivan, who died from a heart attack five months previously.

She lost her baby two days after his birth.

The second day of an inquest into the baby's death at Dublin Coroners Court heard evidence from pathologist Dr Emma Doyle.

The baby suffered some lack of oxygen or stress before delivery, the pathologist said, but she could not give the exact time this occurred.

Delivery had progressed rapidly and staff were not expecting any problems at birth, the inquest heard.

Ms Cullivan had experienced pains but was deemed not to be in labour by a midwife at 10pm. She spent 90 minutes alone in a private room in the hospital, a crucial period during which there was no CTG monitoring of the foetal heart rate, the inquest was told.

During this 90 minute period, Ms Cullivan was having contractions and she became concerned but said she could not reach the call bell. “I was very afraid for our baby, I shouted out for help and I was eventually heard and a nurse came in,” Ms Cullivan said.

Dr Michael O’Grady, consultant paediatrician at Mullingar hospital, said he was called into the hospital about seven minutes after midnight. He said the paediatric team were not aware that an extremely sick baby would be delivered. Dr O’Grady said the hospital in Mullingar dealt with around 2,500 births a year but only two or three of these would require advanced resuscitation.

Chest compressions were commenced shortly after birth and baby Stevie was given the opiate antidote narcan in a bid to counter any effects of pethidine, the pain relief given to his mother two hours earlier. Pethidine can affect the baby’s respiratory effort, the inquest heard.

The infant was stabilised overnight before he was transferred to the Rotunda Hospital in Dublin shortly after 8am. He was gravely ill before he was transferred, Dr O’Grady said.

Rotunda based paediatrician Adrienne Foran described the baby as clinically and profoundly encephalopathic. Withdrawal of care was recommended.

Staff continued to care for Stevie to allow for his mother to spend some time with him. Family and friends arrived and the baby was baptised. He died at 1.40am on April 30th.

The cause of death was severe hypoxic ischemic encephalopathy as a result of an acute hypoxic ischemic event on a background of foetal vascular malperfusion. The baby suffered some lack of oxygen or stress before delivery, Dr Doyle said, but she could not give the exact time this occurred.

Dr Doyle said the placenta was “hyper coiled” with a coil every 2cm, which can affect foetal circulation. “It’s there and it compromised placental function so that any other acute event meant the baby couldn’t appropriately respond,” Dr Doyle said.

With all the evidence heard, coroner Dr Myra Cullinane adjourned the inquest and will deliver her verdict on November 15th.