The former Master of the Rotunda Hospital has told the High Court that an ultrasound scan should have been carried out at the National Maternity Hospital on a woman who was admitted there in the 29th week of pregnancy, and who gave birth to a severely disabled child two days later.
Dr George Henry, consultant obstetrician, said an ultrasound scan would have shown whether the baby was in the normal head down position or in the breach position, and would also have shown the size of the baby.
He was giving evidence on the ninth day of an action brought by Blaise Gallagher, suing through his mother Avril, of Moneystown, Roundwood, Co Wicklow, against the hospital and consultant obstetrician Dr Joseph Stanley.
Blaise was born at the hospital by Caesarean section on April 27th, 1992. He suffers from cerebral palsy and is quadriplegic. Both defendants have denied negligence.
Yesterday Dr Henry said that once it was established that Mrs Gallagher was 29 weeks pregnant and that her membranes had ruptured, her pregnancy became high-risk and unpredictable. A plan for the management of the birth should have been drawn up, and recorded on the hospital notes.
Dr Henry said it was not good practice for hospital staff, when Mrs Gallagher began to feel "twinges", to tell her to keep timing them and to let them know if the "twinges" got shorter.
Rectal examination was not a sensitive way of establishing whether a woman was in premature labour, he said.
Cross-examined by Mr Murray McGrath SC, for Dr Stanley, Dr Henry agreed that certain steps should have been taken to inform Dr Stanley what was occurring at various stages during Mrs Gallagher's time in Holles Street.
Premature labour was a highly unpredictable event and it was a matter for the obstetrician to make a decision on how to deal with it.
If Mrs Gallagher had requested that Dr Stanley be informed of her condition, the request should have been complied with by hospital staff.
Cross-examined by Mr Sean Ryan SC, for the hospital, Dr Henry said that once the membrane had ruptured a woman might go into labour or she might continue her pregnancy for days or weeks. Prematurity was a very significant risk to the baby.
If it was suspected that premature labour was starting, the obstetrician should be informed immediately.
The hearing continues today before Mr Justice Quirke.