Thirteen "significant incidents" where a breech birth was diagnosed in advanced labour occurred in Our Lady of Lourdes Hospital in Drogheda over a two-year period, according to the Health Service Executive (HSE).
The death of a baby in the hospital in 2013 followed an undiagnosed breech and this is under examination by the local coroner, the HSE said in a statement.
An internal clinical audit, prompted by the death, established breech was not diagnosed before labour in 21 cases between May 2012 and June 2014. During this period, 7,667 babies were delivered, with 221 of them in the breech position.
“Overall, approximately 4 per cent of babies will be breech at term. It is widely recognised that even in experienced hands there will be a number of undiagnosed breech presentations in labour,” the HSE said.
“It is important to recognise that these 21 cases are not all critical incidents. Breech diagnosed in early labour is not considered a critical incident and would not usually be reported. However, breech diagnosed in advanced labour is a significant incident and would usually be reported.”
The audit found eight of the 21 cases were diagnosed in very early labour, while 13 were diagnosed in later labour.
According to the statement, the audit was not a review or incident investigation of the 21 cases, but was conducted in order to identify if the rate of undiagnosed breech in the hospital was within an acceptable range.
The rate of undiagnosed breech in the hospital was 9.5 per cent of breech births, compared to an expected rate of 20-25 per cent suggested in international studies.
The 21 births included eight midwife-led patients and 13 in consultant-led units.
In 2007, a coroner returned a verdict of medical misadventure in the case of baby Shane McArdle, who died less than 24 hours after being delivered in a breech position at Our Lady of Lourdes. The breech went undiagnosed.
Babies born in the breech position are delivered buttocks or feet first, as opposed to the head. Many breech births are delivered by Caesarean section.
Last month, it emerged seven births involving oxygen deprivation at Portiuncula hospital in Ballinasloe, two of which resulted in death, are under investigation. Separately, some 170 births in recent years are under review by a HSE panel following complaints from patients about a number of maternity units.
