Fergus O'Dowd
Ceist:228 Mr. O'Dowd asked the Minister for Health and Children if he will institute an immediate inquiry into the high number of symphysiotomies carries out at the Lourdes Hospital, Drogheda. [18010/03]
Written Answers. - Maternity Services.
Arising from concerns about the use of symphysiotomy in obstetrical practice in the past, the chief medical officer at my Department, in April 2001, asked the Institute of Obstetricians and Gynaecologists for its comments and advice on the matter. The institute represents obstetrical and gynaecological opinion in Ireland, acts as an advisory body on matters relating to education, research and administration in the specialty and seeks to raise standards in obstetrics and gynaecology in this country.
The institute replied in May 2001 to the CMO and confirmed that from around 1920 until around 1960 symphysiotomy procedures were carried out on selected patients in Dublin, mainly at the National Maternity Hospital and the Coombe Hospital. In the case of Our Lady of Lourdes Hospital, Drogheda, my Department was informed by the North-Eastern Health Board that 188 such procedures were performed at the hospital in the period 1955 to 1982, with some 158 of these being performed prior to 1970.
The institute advised that excellent results were claimed for the procedure which had the effect of permanently enlarging the pelvis and allowing women to undergo normal delivery. This was at a time when caesarean section had a high mortality rate due to sepsis, one of the leading causes of maternal death at that time. The institute stated that in properly conducted cases complications were rare. Published medical reports of the time indicated favourable results for the procedure. Many of the cases referred to in these reports were emergency admissions with obstructed labour where sepsis following caesarean section would have carried a significant risk of maternal death.
From 1950 onwards, the operation of symphysiotomy for obstructed labour was gradually replaced by the modern caesarean section, as antibiotics were available by then to treat infection and sepsis was less of a hazard. The institute also stated that the operation of symphysiotomy remains an accepted indication for the management of a trapped after coming head of a breech, but that caesarean section is now recommended for all mature infants who present with a breech presentation.
We must be cautious about judging procedures and interventions which were used in previous generations in the light of current knowledge and experience. Enormous medical advances have been made in obstetric practice since the 1950s and procedures were not as advanced then as they are in Ireland today. Under the circumstances, I have no plans to establish an inquiry into the use of symphysiotomy in obstetrical practice. I am aware that a request has been made by a group, representing women who have experienced this procedure, and I have agreed to meet this group on the issue.