Mohammed Ahmed

1.

Mother in particular but also the experienced professionals involved were wholly unprepared both emotionally and technically for a live birth. “Stunned” “shocked” and “distressed” were amongst the epithets given in evidence to describe their reaction to the birth. The Neonatal Team were not present and would not have expected to be present and had to be called urgently to review baby Mohammed.

However well-intentioned - the attempt to reduce the time that a patient waits in the Department after feticide has been performed by minimising the scan time when confirming fetal death contributed to this unintended case of a live birth after termination of the pregnancy.

The Consultant Obstetrician giving evidence confirmed the need to formally record the exact time of the injection as well as confirmation of fetal demise at the “interval scan” which should be at least_20 minutes later with the interval fetal heart check for a full minute to avoid more transient changes than permanent asystole. Following the case involving baby Mohammed written Feticide Guidelines have been implemented (copy attached).

The Consultant Obstetrician agreed that it would be good practice to} contemporaneously record the medication infused, the time of infusion; the time of insertion and withdrawal of needle and the time at which the fetal heartbeat was monitored on ultrasound.

Without intending to be prescriptive I am of the opinion that other Departments nationally which carry out feticide procedures should be aware of the tragic sequence of events which took place in Greater Manchester and should consider the implementation of similar written guidance with documented procedures to facilitate unequivocal confirmation of fetal demise.

Consideration should also be given to the desirability of a leaflet for parents which fully explains the feticide process using appropriately sensitive and lay terminology.