Vinnie Dodds
20 Jul 2021 · Coroner Derek Winter DL · City of Sunderland
The coroner's concerns
1. lack of national guidance for management of large babies
“There is no national guidance for the management of large babies in pregnancy, unless diabetes is present, so it may not be possible to produce a safety recommendation to advise mothers with a suspected large baby”
2. risk of death from shoulder dystocia not communicated
“The risk of death from shoulder dystocia was not discussed and is not included in the current RCOG shoulder dystocia patient information leaflet”
3. inadequate antenatal care regarding large babies
“Although shoulder dystocia is a medical emergency for which staff are trained, it was the elements of the mother's antenatal care which gave rise to concerns notwithstanding the obvious impact of the pandemic”
Responses
2021-0249-Response-from-Dept-of-Health-and-Social-Care_Published.pdf ↗· Department of Health and Social Care
Stated action · 2022/23
“NHSEI advise that there is currently a lack of evidence on the management of large babies in pregnancy (unless diabetes is present), In particular, it is not clear whether the incidence of shoulder dystocia can be reduced through inducing labour in women with big babies or whether it is better to wait for labour to begin naturally. Progress in this area of maternity care should be more clearly informed when the results of the Induction of labour for predicted macrosomia - The 'Big Baby Trial'1”