With reference to this Daily Mail Online article, Tozers’ Group B Strep specialist Stuart Bramley comments on the NHS’s decision to trial Group B Strep screening in pregnant women.

On 1 March 2019, Mrs Justice Yip, High Court Judge found that Dr Stead, a GP had breached his duty of care to a 35 year old patient whom he saw in his “out of hours” clinic. It seems that Dr Stead failed to note ‘red flag’ warning signs for cauda equina syndrome and to refer Mrs Shaw on urgently to hospital.

We are pleased to confirm the launch of an animation video entitled Better care costs less produced by Prompt (PRactical Obstetric Multi-Professional Training), a charity whose aim is to make childbirth safer through evidence-based, multi-professional training and research.

Tom sustained a severe Group II obstetric brachial plexus injury with damage to his C5, C6 and C7 nerves following shoulder dystocia during his birth in 1996. Although Tom’s mother sought to bring a claim in the 1990s she was advised at the time that the case did not have prospects of success. Tom subsequently sought legal representation again in his late teens on realising that his injury was going to have a significant impact on his life.

In 1995 when Sarah (not her real name) was born, knowledge that a brachial plexus injury was preventable was slowly spreading. During labour, after Sarah’s head was delivered, shoulder dystocia occurred, and Sarah’s left shoulder became trapped against her mother’s pubic bone. In the attempt to manage the obstruction, the registrar who dealt with this obstetric emergency pulled too hard on Sarah’s head. The force used damaged 4 of the 5 nerves in Sarah’s brachial plexus: C5, 6, 7 and C8.

Adam* suffered a brachial plexus injury to his right side during his birth in 1998. The C5, 6 and 7 nerves were damaged as a consequence of the medical staff’s efforts to deliver him by pulling on his head when he was stuck during delivery (shoulder dystocia). Early assessments as an infant by specialists at the Royal National Orthopaedic Hospital were optimistic and remedial surgery was therefore not performed. However, as Adam grew his recovery was not as had been hoped and he developed abnormalities including contractures and subluxation of the shoulder joint. He had surgery at 2 years, 4 years and 7 years of age.

Those who follow the news would be forgiven for thinking that 2018 is the year of NHS scandals. Sir Brian Langstaffe’s inquiry into infected blood products, from which 3,000 died and over 25,000 are believed to have been infected, is being heard as separate investigations into hospitals in Shrewsbury & Telford suggest that on evidence available so far, 40 babies have died unnecessarily and another 12 bereaved families have been contacted in case the deaths of their children arose from similar causes.

Each Baby Counts is a national quality improvement programme led by the Royal College of Obstetricians and Gynaecologists (RCOG). Its goal is to reduce the number of babies who die or are left severely disabled as a result of incidents occurring during term labour.

The cauda equina is a collection of spinal nerves and nerve roots below the tapered end of the spinal cord, or conus medullaris. It consists of the second through to the fifth lumbar nerve pairs, all sacral nerve pairs and the coccygeal nerve. These nerve roots are called cauda equina nerve roots because early anatomists thought they looked like a horse’s tail. Cauda Equina is Latin for “horse’s tail”.  The cauda equina nerves control bladder and bowel, sexual function, sensation in the groin area and motor function throughout the legs.

Fraser was born into a sporty family. Unfortunately he sustained a severe group 2 injury when the 5th, 6th and 7th cervical nerves in his brachial plexus were damaged during his birth.  His injury limits the function and range of movement in his left hand and arm, especially at the shoulder.

Luke was born in 1999 and suffered bilateral fractured clavicles and damage to the brachial plexus due to the force used to deliver him. The brachial plexus is the network of nerves that sends signals from the spine to the shoulder, arm and hand, to supply movement and sensation. Tests at 3 months of age confirmed widespread and severe damage to all 5 nerve roots, including avulsion from the spinal cord. Surgery was performed and extensive physiotherapy provided but such degree of damage was beyond repair. 

Spinal cord injuries arise when there is damage to the spinal cord that causes changes in its function. The problems arising from spinal cord injuries can be either temporary or permanent but often result in life changing complications such as: