A planned review of the National Maternity Hospital (NMH) case in which a pregnancy was terminated on the basis of a misleading test result is facing further delay after UK experts declined to become involved.
The London-based Royal College of Obstetricians and Gynaecologists (RCOG), which had been asked by the NMH to review the case, said it did not have the expertise needed. It also expressed doubt that it could complete the work as quickly as was required.
While declining the request from the NMH “after much deliberation”, it has suggested individual clinicians would be in a position to carry out a review more swiftly, and has offered to put the hospital in contact with them.
The case highlights the need to update the information available in relation to “new and evolving technologies”, according to RCOG in its letter to the hospital.
Caoimhe Haughey, the solicitor for the couple in the case, said RCOG's decision meant promises of an independent review were now "in limbo" and it was unclear what would happen.
Review planned
The NMH said a review of the case was still planned. “RCOG has said it will approach experts with appropriate specialist knowledge, ascertain their availability to assist and then put us in touch with them.
“It says it does not have the appropriate specialist knowledge within its own group of assessors, but we are very grateful for assistance in securing someone suitable to lead an independent external review.”
A spokesman for RCOG said it had considered the request from the hospital. “In this particular case, RCOG is unable to undertake the review. It has made alternative recommendations to the National Maternity Hospital in order for the case to be reviewed independently and swiftly for the family and staff involved.”
The woman underwent testing after an initial blood screening, known as the Harmony test, showed she had an elevated risk of foetal anomaly.
The first part of the Chorionic villus sampling (CVS) test indicated a fatal foetal anomaly known as Edward’s syndrome, but this turned out to be a rare false positive.
Termination
The couple say they were told there was no need for them to wait for the result of the second part of the CVS test, which arrived nine days later, before proceeding with a termination. They say they were told by hospital staff there was no need to wait for the second test and that the matter was “black and white”.
The discrepancy arises from a phenomenon known as mosaicism, and arises when the genetic make-up of the placenta, which was sampled for the test, differs from that of the foetus.
The couple initially attended the Merrion Fetal Health, a private clinic at the NMH that offers ultrasounds and other tests to intending mothers. As required under abortion legislation, the woman’s care was transferred to the hospital once a termination was envisaged.
Second test
Ms Haughey said a document from the clinic in relation to the Harmony test, which was included among documents sent to her by the hospital, clearly showed the need for a second test before a termination was carried out.
The document states: “…if you did get a high risk result and you were going to termination the pregnancy we would always recommend that you confirm the diagnosis with an amniocentesis”.
Ms Haughey said her clients had never seen the form and it was never discussed by them
in the clinic.
A hospital spokesman described the document as a “prompt sheet” or training aid used by staff in interviews with patients. He also pointed out that a second (CVS) test was carried out.
