Foetal asphyxiation often due to human error

Findings from a 15-year study indicate that human error is the most common cause of infant asphyxiation at birth.

Inadequate foetal monitoring, lack of clinical skills, and failure to obtain senior medical staff assistance are most often cited in Norwegian compensation claims following birth asphyxia, says the research published in Acta Obstetricia et Gynecologica Scandinavica.

In 2007, around 6.4 percent of stillbirths across England, Wales, Northern Ireland, the Channel Islands and the Isle of Man were due to asphyxia, anoxia or trauma.

“While foetal brain injury or death is uncommon during childbirth, when it occurs the effects are devastating,” explains Dr Stine Andreasen with the Department of Obstetrics and Gynecology at Nordlandssykehuset (Nordland Hospital) in Bodø, Norway. “Our study investigates claims made to the NPE for neurological injury or death following birth asphyxia.”

For the present study, researchers examined 315 claims made to the NPE between 1994 and 2008 that were associated with alleged birth asphyxia. The team looked at hospital records, assessments by experts, along with NPE and decisions made by courts of law. Of the claims made, there were 161 cases that were awarded compensation.

Results show that in the compensated cases there were 107 infants who survived, with 96 having neurological injury, and 54 children who died. Human error was the most common cause of birth asphyxia with 50 percent attributed to inadequate foetal monitoring, 14 percent to lack of clinical knowledge, 11 percent to non-compliance to clinical guidelines, 10 percent to failure to ask for senior medical assistance, and four percent to errors in drug administration. In cases of substandard care, the obstetrician and midwife were documented as the responsible staff at 49 percent and 46 percent, respectively.

“In most compensated cases, poor foetal monitoring led to an inadequate supply of oxygen to the infant,” concludes Dr Andreasen. “Training for midwives and obstetricians, along with high-quality audits, could help to reduce claims for compensation after birth asphyxia.”

Staff Writer