HSE inability to provide data on sepsis raises questions about hospitals

The beginnings of a trend may be emerging in the Republic

The Rotunda hospital: its response – that it was unable to supply information about sepsis – is puzzling. Photograph: Alan Betson.

The Rotunda hospital: its response – that it was unable to supply information about sepsis – is puzzling. Photograph: Alan Betson.

Mon, Jan 6, 2014, 01:00

It is hardly reassuring to learn that, some six months after the publication of its report and recommendations in relation to the death of Savita Halappanavar, the Health Service Executive is unable to provide figures for maternal sepsis because such information is not “collected, collated or reported nationally”.

It raises the question of whether the HSE has even asked individual hospitals to collect basic data in this area?

Bacterial sepsis in pregnancy is defined as serious bacterial illness in the antenatal and intrapartum periods, arising in the genital tract or elsewhere in the body. Puer- peral sepsis refers to a severe infection that occurs after the baby has been delivered.

The use of the term sepsis implies the infection is complicated by systemic manifestations in other organs in the body. Most maternal deaths are linked to infection with a bug called streptococcus Group A.

Severe maternal sepsis may be statistically rare. Giving evidence at Ms Halappanavar’s inquest last April, Dr Peter Kelehan, a retired consultant pathologist at the National Maternity Hospital (NMH) in Dublin, said he had seen fewer than five cases of septic abortion as severe as Ms Halappanavar’s.

A recent UK report said genital tract infection had become the leading cause of direct maternal death for the first time since inquiries into such deaths began in 1952.

Peter Boylan, clinical director and past master at NMH, told the inquest that, despite this recent trend, the mortality rate from maternal sepsis remains low, at about one per 100,000 maternities. Similar figures apply in the Republic: in the past 25 years, during which more than 210,000 women gave birth in the NMH, there were two deaths from sepsis, he said.

But the beginnings of a trend maybe emerging in the Republic, where there were three deaths from maternal sepsis among the 11 maternal deaths recorded in 2012, compared with no sepsis deaths a year earlier.

It is to the credit of the NMH and the Coombe hospital that they responded comprehensively.

The response from the Rotunda is puzzling – it would be suprising if a leading teaching maternity hospital was not collecting key data on maternal sepsis.

But the lack of data from the HSE is not surprising. It has yet to demonstrate alacrity when it comes to the vital issue of patient safety.

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