FOLLOW-UP SCANS:HSE WEST has said that second scans are now "standard" in Galway University Hospital to eliminate the risk of "near miss" incidents involving pregnant women.
HSE West was responding to public confirmation by two women in Co Galway over the past two days that they had also experienced misdiagnosis in the early stages of pregnancy, similar to that experienced by Melissa Redmond at Our Lady of Lourdes Hospital in Drogheda, Co Louth.
Elaine Cunningham, the mother of a five-year-old boy living in Ardrahan, Co Galway, and Martha O’Neill Brennan, a mother of four in Castle Ellen, Athenry, Co Galway, both sought a second opinion after both were informed of miscarriages during scans in Galway University Hospital in 2004 and 2006 respectively.
Both have called for a public inquiry into procedures and practices to ensure there could be no recurrence. They say that second scans – which should be examined by a separate medical team – should be “mandatory” in cases of suspected miscarriage.
Ms Cunningham told yesterday how she had been married for 15 years and had tried unsuccessfully to have children, when she discovered she was pregnant in 2004.
“I was 39, so I wanted the best treatment possible and asked to be seen privately in Galway University Hospital,” she said.
Ms Cunningham told The Irish Times: "My GP had suggested Portiuncula in Ballinasloe, but I did not want the stress of driving there. After about eight weeks, I started to bleed one Friday morning. My doctor advised me to go straight into the maternity ward in Galway. It was a Friday afternoon when I was eventually seen by a doctor; I remember that she was wearing three bleepers on her lapel. She was in the middle of performing an internal probe when a bleep went off and she left me. This happened a second time also, but in the meantime, I asked her what she saw and she said it was an 'empty sac'.
“After she returned from being bleeped the second time, she told me there was no heartbeat and ‘nothing there’. She told me it was ‘nature’s way of getting rid of the bad ones’ and that . . . I would bleed more over the weekend and I should contact my GP on Monday morning, she said. At that stage I just wanted to run out of the hospital – which I think I did.
“My husband [Matthew] was with me and we never spoke in the car coming home. That Friday evening, I cried and cried, but on Saturday I phoned a very good and close friend of mine in the medical profession in Galway and told her . . . what had been said to me.
“She then phoned back to say that she had a good friend working in the maternity unit and, if I came in at 7.30am on Monday, before the scan appointments started at 8am, they would squeeze me in.”
“I was there at 7.20am and the nurse started with an external scan. I said to her ‘well, that’s it, isn’t it’, but she said she felt it was good news. She went out to get a second opinion and came back in to tell me that I was pregnant and there was a good sturdy heartbeat.
“I was overwhelmed and the first thing I did when I got home was to phone my GP and ask if I could be transferred to a gynaecologist in Portiuncula. I got a lovely doctor, had a wonderful pregnancy and my five-year old Seán is the result.
“I don’t feel angry and never spoke about this with anyone but close family, but my heart goes out to women who have had D&Cs and feel they should have had a second opinion. A telephone helpline is not going to change the past.”
Ms O’Neill Brennan said that in 2006, it was only when she insisted on having a second scan before she had a D&C that she discovered she was still pregnant with her now three-year old son, Aaron. She had two boys and had experienced one miscarriage already.
When she began to bleed heavily during the early stages of pregnancy with Aaron, she was told by her gynaecologist during an internal scan that she had miscarried. She declined the offer of a DC later that day as she had to arrange childcare.
When she returned for her D&C appointment several days later, one of the hospital staff kept advising her that she would lose her place in theatre if she insisted on having a second scan.
“When I did have a second scan, and found I was still pregnant, they called my doctor in from theatre. He asked how I was feeling. I asked him how he would feel if this was his sister or daughter in my position. As he turned to walk out, he told me that I was seven weeks pregnant and ‘not out of the woods yet’. I asked to be transferred to a more senior obstetrician.”
Ms Cunningham did not file a complaint as she wanted to put the experience behind her, but Ms O’Neill Brennan engaged in eight months of correspondence with the HSE West and put 11 questions to the doctor involved.
She was told by the hospital that a system of second scans would be put in place, but when she mentioned this to the senior obstetrician, he intimated that there would be “no change in practice”.
HSE West said an “incident” had occurred in August 2006, where a patient had an incorrect diagnosis of a “missed miscarriage” and a review was undertaken.
“The measures put in place in Galway University Hospital since 2006 include that a second opinion from another healthcare worker is given in cases where a foetal heartbeat is not seen or heard. If there is still no foetal heart beat recorded, then a second scan is performed to ensure an accurate diagnosis takes place.
“There is a level of uncertainty in ultrasound scanning in that scanning is not infallible, especially in the early stages of a pregnancy. It is rare but situations can occur when a scan will suggest that the pregnancy is lost but subsequent scans may show a foetal heartbeat,” HSE West said.
“Repeat scanning is undertaken when appropriate. The HSE’s clinical programme for obstetrics and gynaecology has identified the need to introduce standard national guidelines and care pathways across the country to ensure that the international criteria for the management of non-viable pregnancy are being followed.”