Obstetricians challenge Boylan inquest evidence

Reducing the Savita Halappanavar case to a debate about abortion may lead to more, not fewer, deaths in the future, a group of obstetricians has claimed.

All obstetric units in Ireland need to reflect on the findings of the inquest into Ms Halappanavar's death and learn how to improve care for pregnant women, the eight obstetricians and three other consultants say in a letter to The Irish Times .

The group, which includes a number of figures who have spoken at pro-life events, argues that the expert evidence given by clinical director at the National Maternity Hospital, Dr Peter Boylan, at the inquest was a personal view rather than an expert one.

“It is impossible for Dr Boylan, or for any doctor, to predict with certainty the clinical course and outcome in the case of Savita Halappanavar, where sepsis arose from the virulent and multi drug-resistant organism, E.coli ESBL.”

“What we can say with certainty is that where ruptured membranes are accompanied by any clinical or bio-chemical marker of infection, Irish obstetricians understand that they can intervene with early delivery of the baby if necessary.”

Among the signatories of the letter are Eamon O'Dwyer, retired professor of obstetrics and gynaecology at NUI Galway, Dr John Monaghan, consultant obstetrician-gynaecologist at Portiuncula Hospital in Ballinasloe and Prof Stephen Cusack, consultant in emergency medicine at Cork University Hospital.

The diagnosis of chorioamnionitis (inflammation of the foetal membranes) was delayed and relevant information was not noted and acted upon in Ms Halappanavar’s case, the letter claims.

The obstetricians say the facts as produced at the inquest showed the case to be “primarily about the management of sepsis”.

Dr Boylan’s opinion on the effect of Irish law “did not appear to be shared by the coroner, or the jury”.

The group points out that maternal sepsis is increasing and is now the leading cause of maternal death in the UK.

They say there are “many well-documented fatalities” from sepsis in women following termination of pregnancy.