Parents of newborns who died a week after birth question the lack of Strep B testing

The parents of a newborn who died a week after birth questioned why Britain does not screen for group B strep, an investigation into fatal accidents has revealed.

Freya Murphy was born on July 21, 2018 at Queen Elizabeth University Hospital (QEUH) in Glasgow, but died a week later in the neonatal intensive care unit, a fatal accident inquiry (FAI) at Glasgow Sheriff Court heard.

In a victim impact statement, mother Karen Murphy and her husband Martin said they are “devastated by the failings in her care” and have “missed a lifetime of memories with our precious daughter”, while their other children “suffer daily without their big sister”.

They added: “We are concerned that most developed countries are investigating Group B streptococci, but not in Britain.”

Ms Murphy, then 32 years old and a first-time mother, was considered a ‘low risk’ pregnancy and the induction was scheduled for July 20, 2018, but she requested the pregnancy be postponed by three days, a statement said. of agreed evidence read to the court.

Fiscal depute Amanda Allan told the court that on July 19, Freya’s heart rate was recorded as 150 beats per minute (bpm), and Mrs Murphy, a teacher from Cambuslang, South Lanarkshire, went into labor later that day.

The following evening, Mrs Murphy arrived at QEUH with a fetal heart rate of 144 beats per minute. She was taken to the labor ward around 10:20 p.m. At 6.30am on July 21 she was advised to start pushing, the inquest heard.

At about 7.20am a midwife noticed that Mrs Murphy’s pulse was elevated and informed Dr Felicity Watson, who had carried out a vaginal examination, and advised Mrs Murphy that she could “rest from pushing for an hour”, which she refused. do, Ms Allan told the court.

Midwife Helen Kidd reported at 8.45am that a CTG (cardiotocograph) showed signs of “slowing”, but Dr. Amy Sinclair and Dr. Marieanne Ledingham left to visit another woman, Patient A, the court heard.

At the time there were twelve women on the ward, including seven in labour, and Dr Ledingham returned to examine Ms Murphy and noticed “slowing”. Dr. However, Sinclair told her that Patient A required a surgical delivery.

The court heard that Dr. Sinclair and Mrs Kidd delivered baby Freya at 9.30am “covered in copious thick meconium”.

Mrs Allan said: “Freya was found to have been born in poor condition, she required resuscitation and the resuscitation lasted 17 minutes.”

Freya was then transferred to the neonatal ICU and it was suspected she had suffered a brain injury, the inquest heard.

Ms Allan added: “It was agreed that continuing treatment in intensive care was not in Freya’s best interests and that she was unlikely to survive.”

Freya died just before 10pm on July 28, aged one week, and her cause of death was global hypoxic ischemic brain injury associated with acute chorioamnionitis, following a post-mortem examination.

In 2019, a significant clinical incident study was conducted with six recommendations, and an external review was commissioned by Dr. Michael Munro, a neonatal specialist who wrote in a report that “amnionitis caused by group B streptococci is the most likely cause of Freya’s brain remains. injury as there appears to be nothing else that could cause it,” noting that after birth “care was provided at (a) high level,” the court heard.

Dr. Giving evidence via video link, Munro said: “The trajectory of the decline is really impossible to be sure of, there are no studies that I am aware of into the specific circumstances Freya found herself in. The process of that beginning and the baby dying can take less than 30 minutes.”

Dr. Munro said he believed that group B streptococcus – an infection passed from the mother’s body to the baby through the amniotic fluid – was “the most likely cause as I have seen nothing else from the notes to explain what happened.”

He said: “It can cause a stillbirth, which is why we are dealing with a stillbirth just before Freya’s heart tragically stopped.”

He agreed that an earlier delivery would have helped, but added: “I don’t think it is possible to say, ‘If Freya had been delivered at this time she would have avoided brain damage or survived’. ”

Dr. Munro told the court that the mortality rate (from group B strep) is “around 5%, it is a minority of babies who succumb” and Freya was “almost admitted as a stillbirth” because her heart rate was so low.

He added: “Many women carry Group B strep, about a third – it affects a very small number of babies, causing stillbirth or a baby being born in a very poor condition.”

Dr. Munro said screening for group B strep has been carried out in America since 2002 and that 15,000 babies born in Scotland in 2023 could have been affected by the infection.

He said the “risk of exposing many babies to antibiotics they don’t need” was an important consideration for doctors, but added: “I would like universal screening. One of the most advanced healthcare systems in the world is doing this and you have to wonder why Britain isn’t doing it.”

Under cross-examination by Alan Rodgers, representing the Murphy family, Dr Munro said “the most common sign was fever in the mother and the heart rate could increase”, the inquest heard.

Giving evidence, neonatal pathologist Dr Paul French said the placenta had been examined before Freya’s death and was stained with meconium, indicating the baby had been ‘stressed’ before birth – but said this would have been ‘hours or days’ earlier happened, and that Strep B was present in smears.

The investigation continues in the presence of Sheriff Barry Divers.