Twin to Twin Transfusion Syndrome

A Worcestershire woman has told of her anger after discovering that a routine scan during early pregnancy could have prevented the death of her twins in 2005.

Her case, which was settled out of court this week by her solicitors, Irwin Mitchell, echoes many of the points raised in a damning report published by Sands, the stillbirth and neonatal charity. This outlines the fact that many deaths could be avoided by better antenatal care and more funding research.

The last official enquiry by CESDI, the Confidential Enquiry into Stillbirths and Deaths in Infancy, concluded that nearly half of all unexplained stillbirths might have been avoided with better antenatal care.

Stella Bate's identical twin girls had been suffering from 'Twin to Twin Transfusion Syndrome'* (TTTS) – a condition only affecting twin pregnancies where both babies share one placenta. If detected and treated early during pregnancy, there is a high survival rate of at least 70%.

However, staff at Worcestershire Royal Hospital treating 34 year old Ms Bate from Kidderminster, failed to commence routine scanning at 16 weeks pregnancy.

On 8th May 2005 at 20 weeks, Ms Bate developed severe back and abdominal pain. She was admitted to hospital but she was wrongly diagnosed with a urinary infection and sent home without an ultrasound scan. The pain became worse overnight and Ms Bate returned to hospital the following day but again no scan was performed and she was sent home once more.

By 14th May, Ms Bate became so concerned that she again contacted the hospital but was told there was no cause for concern.

It was not until the following day, on 15th May 2005 that Ms Bate was admitted to hospital. Even then it took more than two days for the hospital to perform a scan and and it was only at this point she was given the devastating news that her twins were suffering from TTTS.

Ms Bate was transferred from Worcestershire Royal to the specialist Birmingham Women's Hospital on 18th May where she underwent treatment. On 23rd May she went into premature labour and despite the best efforts of obstetric staff, both babies were delivered stillborn.

Despite an undisclosed compensation settlement, Worcestershire Acute Hospitals NHS Trust has refused to accept liability for the twins' death and has not offered an apology. However, as a direct result of this case, the Trust has changed maternity procedures so that all such twin pregnancies are now routinely scanned from 16 weeks gestation rather than at 24 weeks.

Ms Bate commented: "I feel so angry and upset because despite going through the NHS complaints process and taking legal action, the Trust has just brushed me off.

"TTTS is treatable and has a high survival rate of at least 70% if it is picked up early enough, but my daughters, Sophie Jane and Chloe Anne, were not given that chance and I find it very hard to cope with that knowledge."

Guy Forster a medical negligence expert with leading law firm, Irwin Mitchell, represented Ms Bate in her legal action. Speaking at his Birmingham offices, he said: "Aside from the fact that the Trust did not carry out routine scans at 16 weeks back in 2005, there was a number of opportunities when Stella attended the hospital and warning signs were missed.

"Independent medical experts have told us that hospital staff should have been actively looking out for such warning signs in a twin pregnancy like this, but the staff failed to appreciate until it was too late what they were dealing with. In all likelihood both of Stella's twin girls would have survived had she received proper care.

"Although the Trust has now paid compensation, it is a hollow victory for Stella because the hospital has not apologised to her or accepted that its staff members were negligent in any way.

"The Trust's change in procedure for routine scans comes too late for Stella, however, it is hoped that future tragedies can be prevented."