Delay in diagnosis of post-delivery haemorrhage leading to Asherman’s Syndrome

Posted by Patricia Wakeford, 26th June 2018
Mrs B was very pleased to be pregnant as she married in her late 30s. She wanted children and tried for a baby as soon as she was married. In early 2015, Mrs B was admitted to hospital after spontaneous rupture of membranes 10 days before her due date. Her labour progressed but unfortunately she required an emergency Stage 2 caesarean section due to her baby’s position. During the procedure, Mrs B suffered a haemorrhage of just under 500 mls.

Two weeks post-delivery she was admitted to hospital with a secondary post-partum haemorrhage. She had signs and symptoms typical of low haemoglobin. Mrs B was treated with antibiotics; had an ultrasound scan and was starved ready for surgery. The scan demonstrated an irregular lining of the uterus.  The consultant decided to discharge Mrs B without performing the surgery to remove retained products of conception. This was despite Mrs B having symptoms of significant blood loss.

Two days later Mrs B was readmitted with further blood loss. She was again discharged home. The same day she was readmitted with continuous bleeding. A further scan demonstrated retained products and medical management was considered appropriate. This meant giving medication to cause the uterus to contract with the hope that it would expel the retained products. Mrs B required two units of blood by this point.

During the night Mrs B suffered further haemorrhage. The total was recorded to be 3000-3500 mls; a life threatening amount of blood to lose. Emergency surgery took place. Mrs B was nursed on intensive care post-surgery and discharged home four days later.

Mrs B contacted Patricia Wakeford (a former midwife). During the course of the investigations; it became clear that Mrs B was unlikely to have children without clinical intervention. Our expert gynaecology and infertility expert stated that damage had occurred to the lining of the uterus during the emergency surgery which meant that it was highly unlikely that Mrs B would have another baby without assistance and due to her age; time was of the essence. She was subsequently diagnosed with Asherman’s Syndrome.

The trust initially denied liability. Court proceedings were issued. The trust then made some admissions in their defence and negotiations commenced.  Mrs B was happy to accept a five figure sum that will allow her to obtain the treatment that she needs to have another baby.

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