A newborn infant passed away at just four days of age after experiencing brain injury caused by insufficient oxygen, an inquest was told.
A specialist children’s pathologist who performed the post mortem examination on Jac Lewis indicated the oxygen deprivation most likely happened during the birth process via emergency caesarean section at the Grange University Hospital.
Dr Andrew Richard Bamber also informed Gwent area coroner Rose Farmer there could be additional factors she might consider adding to the cause of death.
The inquest has previously heard how Jac’s mother Ceri Lewis believed she was dismissed and received no attention when experiencing intense pain and nausea after arriving at the Cwmbran facility for an induced labour on November 1, 2024.
Dr Bamber, who practises at the University Hospital of Wales in Cardiff and the North Bristol NHS Trust, further explained to the inquest that Jac’s placenta was abnormally small, weighing roughly 300 grams when the typical weight at 38 weeks gestation is 500 grams.
He stated it was not possible to determine why the placenta was undersized, though diabetes, which Mrs Lewis suffers from, can lead to a smaller placenta. He added that an undersized placenta does not necessarily result in complications for infants.
However, a small placenta means there is considerably reduced capacity to cope if circumstances arise that interrupt an infant’s oxygen supply, according to Dr Bamber.
The reduced margin for coping exists because the placenta is already under strain, he explained.
He characterised the small placenta as likely a significant contributing element but stressed this does not rule out other factors beyond his assessment that may have played a role.
Dr Bamber stated Jac was a typically developed infant and the oxygen deficiency probably took place near the time of birth, which could have been briefly prior to, during, or following delivery.
He additionally observed Jac required resuscitation on two occasions after being born.
Andrew Morse, acting for Jac’s parents Ceri and Matthew Lewis, along with Samantha Paxman representing the Aneurin Bevan University Health Board that operates the Grange Hospital, both indicated to Ms Farmer that a conclusion containing a narrative description of the circumstances might be suitable.
Mr Morse mentioned the family had worries regarding inconsistencies in the approaches described by midwives who had given testimony earlier in the proceedings, and how concerns raised by Mrs Lewis during induction might have been escalated.
Ms Paxman reminded the coroner that since Jac’s death the health board has implemented changes, including an extra midwife on each shift, placement of ECG machines to track foetal heartbeats in every room on the ward, and monitoring of foetal heart rate every six hours rather than every twelve in high-risk pregnancies, which surpasses national guidance requirements.
Coroner Ms Farmer is anticipated to deliver her findings later today, Thursday, March 26.