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25 November, 2015

Pregnant Woman In Excruciating Pain Went Back To Hospital 6 Times Before Being Offered Ultrasound Scan - Revealing Her Womb Had No Amniotic Fluid



Waking one January morning in 2012, Rose Moody had an uneasy feeling. She was eight months pregnant with her first child and, unusually, had slept through the night, uninterrupted by the baby kicking.
Rose, 27, from Stone in Staffordshire, had recently moved house and at first she and her husband, Chris, thought the move might have been stressful for the baby, hence the lack of kicking.
'But when I still hadn't felt any movements by the next day, I decided to go and get checked out.'

At the maternity unit, midwives performed a cardiotocography (CTG). Here, an ultrasound probe is placed on the mother's abdomen to record the baby's heart-rate for about 30 minutes, producing a printed graph to check for signs of distress.
The midwives told Rose the readings were normal. But she didn't feel reassured.
'Although I did feel some kicks, over the next two weeks they were less frequent than normal and I started to suffer a constant stabbing pain in my tummy,' she says. 'I went back to the unit several times but each time the midwife said the CTG was normal. They said the pain was just the pressure of the baby.'

On her sixth visit to the maternity unit in two weeks, with the pain now so excruciating she could barely stand, a consultant noticed her in the waiting room and decided to perform an ultrasound scan.
'She looked at the screen and just frowned and went silent,' recalls Rose.
The scan revealed there was no measurable amniotic fluid - which helps the foetus to move in the womb, helps the lungs to develop and keeps the baby warm - so Rose needed to be induced as soon as possible.

The next morning, her son, Archie, was delivered at 37 weeks, weighing 6lb 11oz.
Archie, now three, has suffered health problems including stunted growth, reflux and an allergy to cow's milk, which Rose believes are linked to the distress he suffered in the womb.
She still shudders to think what could have happened, though. 'I look at Archie and can't believe how close I was to losing him.'
Almost one baby in every 200 born in the UK is stillborn - defined as when a baby dies after 24 weeks of pregnancy - with more than 3,600 stillbirths every year. Last week, an expert inquiry found that hundreds of these deaths happen because hospitals fail to make basic checks or to follow national guidance.
The study, led by a team at the University of Leicester, found that in more than half of cases there were gaps in care that might have affected the outcome.

While the cause of stillbirth is not fully understood, in many cases there are problems with the placenta or the baby's heart rate. Both can be detected by monitoring - but the researchers found that, while half of the mothers studied had contacted their maternity unit with concerns about changes or reductions in their baby's movements, in many cases opportunities had been missed to save the baby. These included not investigating or misinterpreting the results of the CTG, which is sometimes also called a foetal heart trace.
This year, a review in the journal The Obstetrician & Gynaecologist called for better monitoring to prevent stillbirth. The author, Gordon Smith, a professor of obstetrics and gynaecology at the University of Cambridge, said this could help detect babies at risk, who could then be delivered early.
In a healthy baby, the heart rate has regular accelerations lasting for 15 to 20 seconds, usually when the baby moves.
If these are absent, the baby may lack oxygen and be trying to conserve resources.
But as Rose's story shows, the CTG test - in use since the Sixties - is not always reliable. Traditionally, a CTG graph is analysed visually by hospital staff. But in his review, Professor Smith called for all maternity units to use computerised CTG, in which the baby's heartbeat is analysed by a computer, which flags up any signs of a problem.



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