Baby died after ‘exceptionally rare’ umbilical cord tear

A baby died due to an “exceptionally rare” tear in the umbilical cord that occurred minutes before he was born, an inquest has heard.

Casey Lynch Byrne was unresponsive after his birth at the Coombe Women & Infants University Hospital, Dublin on July 10th, 2016. Midwives told Dublin Coroner's Court that, when born at 3.54am, a large clot covered Casey's legs.

Casey's mother, Sabrina Lynch (36), of Tallaght, Dublin, had been examined on arrival at the hospital 44 minutes earlier and was found to be in active labour.

Midwives last detected a foetal heartbeat at 3.45am, minutes before active pushing began in the delivery suite. Ten minutes later an emergency team of paediatricians arrived to treat the baby, who was pale and not breathing.

Casey was resuscitated and took his first spontaneous breath 16 minutes after birth. However, he had suffered significant brain damage due to a lack of oxygen.

‘Unpreventable’

Dr Peter Kelehan, a pathologist, said the child suffered an "unexplained, unpreventable natural occurrence that was exceptionally rare".

The cause of death was acute hypovolemic shock due to blood loss as a consequence of a spontaneous tear in the umbilical vein. The torn vein was situated in the umbilical cord, which was attached to the margins of the placenta, which occurs in around 15 per cent of pregnancies. A cord attaching to the edge of the placenta can leave it more vulnerable to injury, the court heard.

The tear, which was unexplained, could have resulted from the baby’s own movements, the inquest heard.

“Babies can kick very hard and sometimes bruise the placenta,” Dr Kelehan said. “The baby has no sensation of hurting its placenta when it kicks it. The baby normally wouldn’t kick through a vessel like this. But the vessel was in a vulnerable place.”

As the bleed from the tear had formed a clot, Dr Kelehan said it may have happened around 10 or 15 minutes prior to delivery.

Casey’s parents were informed of the gravity of the situation and he was pronounced dead in their company at 10.35am on the day of his birth.

Coroner Dr Myra Cullinane returned a verdict of death due to natural causes.

“It’s very tragic. He was a perfect little baby boy and something happened in the moments before delivery which tragically he was unable to recover from,” she said.