Hospital said one test result was enough before termination, says couple

Controversy continues over National Maternity Hospital treatment as second test showed no fatal foetal anomaly

The couple  say they were told there was “no hope” and that the next stage of testing “would make no difference”. Photograph: Bryan O’Brien/The Irish Times
The couple say they were told there was “no hope” and that the next stage of testing “would make no difference”. Photograph: Bryan O’Brien/The Irish Times

The couple at the centre of the National Maternity Hospital controversy say they were told there was no need for them to wait for a second test result before proceeding with a termination.

After an initial test indicated their baby had a fatal foetal anomaly, they were faced with a decision of whether to proceed with a termination or to await the result of a second test, which had been performed on the same tissue sample. This takes another nine days to arrive after the result of the first test.

The couple say they were told by hospital staff there was no need to wait for the second test and that the matter was “black and white”, The Irish Times understands.

They say they were told there was “no hope” and that the next stage of testing “would make no difference”.

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In very rare cases, there can be a divergence between the results of the first and second tests.

In this case, the first test produced a false positive, in that it showed signs of a foetal anomaly known as Edwards’ syndrome, whereas the baby had no anomaly, as the second test ultimately showed.

This phenomenon is known as mosaicism, and arises when the genetic make-up of the placenta, which was sampled for the test, differs from that of the foetus. The CVS test is regarded as 99 per cent accurate, but in 0.15 per cent of cases, a false positive can occur, according to the research literature.

The woman in the case, who had researched the issues involved extensively, says she specifically raised the issue of mosaicism, but says her concerns were dismissed.

The couple say they were “actively” told not to wait and that there was no need for amniocentesis - a further test that can be done at a slightly later stage in the pregnancy. Amniocentesis tests cells directly from the foetus.

They maintain they were prepared to wait for the result of a further test but were told the diagnosis from the initial test was “conclusive”.

They say they asked: “Is there any hope? Is there anything else a test could show?” but were told there wasn’t and that their baby had “full-blown” Trisomy18, or Edwards’ syndrome.

On Saturday the hospital said: “The National Maternity Hospital does not disclose the content of any meeting between doctors and patients. We always respect patient confidentiality”.

The couple say any implication that has been made that they were not prepared to wait for further test results before proceeding with a termination is “unfair and wrong”. They are upset and distraught at what has happened, and at their interactions with the hospital.

The procedures followed by the hospital do not accord with those followed in the Rotunda Hospital and the Coombe hospital in relation to awaiting the results of a second test before carrying out a termination, they claim.

The hospital has proposed an independent review of the case, which is likely to be carried out by the Royal College of Obstetricians and Gynaecologists in the UK. The terms of reference of this review are likely to be agreed next week.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.