By Life Zone
Bimbo Onanuga
The death of a Nigerian-born woman in a Dublin hospital in 2010 was the result of a previous abortion that had perforated her uterus. Bimbo Onanuga (32), who lived in Finglas, Dublin, died on March 4, 2010, from massive internal bleeding. The inquest into her death returned a verdict of medical misadventure.
Ms Onanuga’s uterus ruptured after she was medically induced at the Rotunda Hospital to deliver her stillborn baby. She was seven months pregnant at the time. Doctors discovered the rupture during an emergency caesarean section after she went into cardiac arrest. The coroner’s court heard that the baby had delivered through the rupture into the abdominal cavity. She was subsequently transferred to the Mater Hospital where she died later that day.
The inquest had previously heard the post-mortem found that the placenta had implanted at a part of the uterus which had previously been weakened and thinned by scarring. This was the site of the rupture. Ms Onanuga had previously had an abortion, and Dr Sam Coulter-Smith, Master of the Rotunda, said that it was “probably reasonably safe to assume” that the scarring had been caused by an unrecognised perforation during that abortion which predisposed her to rupture.
The family had raised concerns about the use of ulcer medication misoprostol, which is not licensed for this purpose, in the induction of Ms Onanuga’s labour. Director of Scientific Affairs at the Irish Medicines Board Dr J M Morris told the inquest that misoprostol is not approved for use to induce labour, either in Ireland or in the UK. Such “off-label” use is common, but is done on the responsibility of the doctor who gives it. Dr Morris confirmed that the safety data the IMB has for misoprostol is for oral administration, not for internal administration as is sometimes used for pregnant women.
In his evidence, Dr Coulter-Smith said there are risks when using misoprostol if there has been previous scarring or perforation of the uterus, but there was nothing in Ms Onanuga’s medical notes to indicate such a risk. Although doctors at the Rotunda were aware of the earlier abortion there was no information in relation to any complication that may have occurred. The scarring due to the previous abortion only came to light during the post-mortem examination.
Dr Coulter-Smith was asked by the coroner if the use of the drug used, misoprostol, was a factor in the uterine rupture that led to Ms Onanuga’s death. He answered that the induced contractions led to the rupture and he did not think the drug used to induce those contractions was a factor.
Returning a verdict of medical misadventure, Coroner Dr Brian Farrell said that the principal risk factors were the pre-existing scar and the misoprostol which caused the uterine contractions.
Editor’s note. Life Zone is a prominent Irish pro-life organization. This post appeared at prolifeinfo.ie.