A spokesperson of Tu Du Maternity Hospital in Ho Chi Minh City stated at a press conference on Tuesday that there were no medical errors involved in the death of a 40-week fetus last month despite its parents' claim that doctors were at fault.

The incident occurred on December 28, 2019 when Nguyen Van Quy, a 31-year-old man living in Binh Thanh District, took his wife, N.T.K.D., to Tu Du for tests after she had had bloody vaginal discharge in the 40th week of pregnancy.

According to Quy, the fetus had a normal heart rate of 150 beats per minute upon his wife’s admission to Tu Du.

Routine examination results at the hospital had also showed no abnormalities in both the fetus and mother from the start of pregnancy until the 39th week.

However, D. noticed an increase in vaginal discharge between 5:00 pm and 9:00 pm on December 28.

Quy said that he continuously reported his wife’s bleeding to the on-duty medical staff at the infirmary for several times during that period.

“The staff kept telling me that was a normal sign [that my wife would go into labor soon],” Quy said.

The staff also told the 31-year-old husband that “there was no other way than waiting for your wife’s cervix to open up further.”

The complication

However, at 10:30 pm on December 28, it became so difficult to detect the fetal heart rate that doctors had to resort to medical ultrasonography.

The results showed no heart rate, which means that the baby had died in the womb.

“At that time, doctors told me that they could only perform a surgery to take the unborn out to save the mother as our baby’s heart had already stopped beating,” Quy tearfully recalled.

At around 1:00 am on December 29, Nguyen Thi Kim Hoang, head doctor of the shift during which the incident had happened, directly explained to Quy’s family that his baby’s death was due to a “placental abruption and nuchal cord” incident.

A nuchal cord occurs when the umbilical cord is wrapped around a baby's neck inside the uterus, while placental abruption is when the placenta partially or completely separates from the inner wall of the uterus before delivery, possibly decreasing or blocking the baby's supply of oxygen and nutrients and causing heavy bleeding in the mother, the hospital said at a press conference on Tuesday.

However, Quy disagreed with this explanation and wanted the hospital to clarify the responsibility of the team in charge since his wife was admitted to the infirmary until the fetus died.

Quy insisted that the staff were irresponsible and indifferent, as they did not offer any solution for intervening before the baby’s heart stopped beating although his wife showed various abnormal symptoms such as heavy bleeding and abdominal pain.

The explanation

Speaking at Tuesday’s press conference, Nguyen Ba My Nhi, deputy director of the hospital, affirmed that all the process of examination, follow-up check-ups and emergency surgery for patient N.T.K.D. had been performed without any professional errors on the part of the medical staff.

Dr. Nhi clarified that the doctors initially planned to have D. deliver the dead fetus by vaginal birth, but turned to surgical removal finding signs that the placenta had separated early from the uterus.

In addition, images on screen monitors during the surgery to take the baby out showed that the umbilical cord was tightly wrapped around the child’s neck for two times.

“Mr. Quy was invited to the surgery room to watch the scene,” Dr. Nhi said.

According to Dr. Nhi, D.’s routine ultrasonography results had not showed any sign of the knotted umbilical cord, which then led to a complete interruption of normal blood, nutrient, and oxygen exchange between the mother and her baby.

The incidence of a true knot of the umbilical cord is not only very rare, taking up only 0.3-2 percent of all pregnancies in the world, but it is also often undiagnosed antenatally when present despite the availability of prenatal ultrasonography, Dr. Nhi explained.

“If the doctors had discovered the knotted umbilical cord via ultrasonography by chance, they could have taken the baby out [alive],” she added.

As a mother, Dr. Nhi said that she could empathize with the pain and loss that Quy’s family is suffering from.

“Regardless of whether our failure to protect the baby is due to objective or subjective reason, or medical risks, we all feel sorry for the patient,” she said.

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