Nothing wrong with foetus, postmortem doctor says

No indication foetus would not have progressed to full term had mother not contracted infection

Dr Michael Tan Chien Sheng at Galway County Hall for the inquest into the death of Savita Halappanavar who died at Galway University Hospital last year. Photograph: Brenda Fitzsimons

Dr Michael Tan Chien Sheng at Galway County Hall for the inquest into the death of Savita Halappanavar who died at Galway University Hospital last year. Photograph: Brenda Fitzsimons

Thu, Apr 18, 2013, 06:00


There was “nothing wrong” with the 17-week foetus miscarried by Savita Halappanavar, and there was no indication the foetus would not have progressed to full term had she had not contracted an infection.

Dr Michael Tan Chien Sheng, consultant histopathologist at Galway University Hospital, said the foetus might have shown signs of having been infected with the E.coli infection that killed her mother but otherwise was normal.

Dr Chien Sheng carried out the postmortem on the foetus, a girl, on November 2nd. The baby girl had been delivered spontaneously, after the foetal heartbeat had stopped, on October 24th. Her mother died four days later.

Praveen Halappanavar, who had asked to be excused for testimonies on the postmortems on his late wife and daughter, left the courtroom as Dr Chien Sheng was about to take the stand.


Vital measurements
Dr Chien Sheng listed the vital measurements of the stillborn foetus. He said her scalp was “normal with minimal amount of hair” and her ears were normal, her eyes were fused and her nose normal. “The mouth appears normal. The colour is normal. The chin is well-developed and the neck is normal.”

He said the feet were normal and the left hand had five digits while the right had five, though one of these had an “accessory digit”. He gave the weights and appearance of the foetal vital organs. The liver weighed 0.8g and appeared somewhat decomposed. It was located in the normal position. “The diaphragm is normal. The shape of the stomach is normal. The intestines appear normal.” A skeletal survey showed no sign of bone deformities. He said all the foetus’s organs were consistent with her gestational age.

Dr Chien Sheng said he had taken a swab from the foetus and a culture from this showed E.coli infection resistant to most antibiotics. He said, however, this did not necessarily mean the foetus had been infected. The positive result had come from the cultured sample from the swab and the site the sample had been taken from might have been infected, rather than the whole foetus. “I did not see any evidence to suggest an immune response to the bacterial infection,” he said.


Immune response
However, the foetus might have become infected, as a foetus so young might not have been able to mount an immune response. “We are talking about a foetus that is less than 20 weeks old. It is a well-known fact that a foetus less than 20 weeks might not yield a proper immune response to bacteria.”

Asked by coroner Dr Ciarán MacLoughlin if this had been a “normal developing foetus”, Dr Chien Sheng answered “yes”.

Dr MacLoughlin turned to the jury and said this was significant because frequently miscarriage at this gestation was an indication that there was “something wrong with the baby, and incompatible with life . . . but we have proved, so far as we can see, that there was nothing wrong with this baby.”

Earlier, two witnesses who gave evidence last week were recalled. Dr Ikechukwu Uzockwu and midwife Ann Maria Burke stood by their testimonies regarding a phone call, the timing and contents about which they had given conflicting accounts.