Baby may have had brain injury before birth, inquest hears

A baby boy who died days after his birth may have suffered a brain injury a week before he was born, an inquest has heard.

In evidence described as “game-changing”, a pathologist’s report found that an incident that could potentially have contributed to baby Darragh Byrne’s death from hypoxia occurred before he was born.

At Dublin Coroner's Court, parents Maree Butler and Eoin Byrne from Portlaoise, Co Laois, heard pathology evidence from consultant neonatal pathologist at the Coombe Women and Infants University Hospital, Dr Colette Adida.

The court heard that Dr Adida found evidence of both acute and chronic hypoxia and the latter could have been caused by an event in the weeks before the child's death.

As the inquest got under way this week, coroner Dr Brian Farrell heard that the Coombe hospital issued an apology for failures relating to aspects of the management of Ms Butler’s care during labour, relating specifically to a 1½-hour period before birth.

Cause of death

The cause of death was multi- organ failure due to hypoxia (lack of oxygen), according Dr Adida.

However, from her postmortem, she said it was not possible to give the exact cause of the hypoxia, which was described as a “global cerebral hypoxic change” that caused the baby’s death.

The pathologist found evidence of chronic hypoxia in the form of non-fatal impairment of the placental function and foetal circulation, which she said could take “a few days to weeks to develop”.

“I can’t give the exact timing. It takes days to weeks to happen. I can’t be more precise than that,” Dr Adida said.

Simon Mills, for the Health Service Executive and the hospital, apologised for his use of a colloquial term but said the pathology evidence was a "game changer".

Sara Antoniotti, for the family, said the evidence was “entirely inconsistent with what we have been told by our experts”.

Born on February 15th, 2013, baby Darragh was unresponsive at birth and died four days later.

The court heard that Ms Butler had developed gestational diabetes during pregnancy.

On the labour ward leading up to delivery, progress was deemed slow and oxytocin, a drug used to induce labour, was administered.

The court heard that a cardiotocography scan had been unreadable from about 11am onwards and that at 12.30pm, a decision was made to deliver the baby in the fastest possible manner.

Instrumental delivery was deemed unsuitable and baby Darragh was born by Caesarean section at 1.06pm but he was unresponsive and had no brain activity.

Adjourning the inquest until March 8th, Dr Farrell said "This [pathology evidence] is a crucial issue that I need to look at."