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Inquest Husband held hand of wife who died after giving birth as doctors tried to revive her

"Now, we will never be able to hear her voice or see her again. My daughter never got a chance to meet her mother."

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The late Nayyab Tariq. Photo Conor McKeown

The late Nayyab Tariq. Photo Conor McKeown

Ayaz Ul Hassan attending the inquest into the death of his wife Nayyab Tariq in Swinford, Co Mayo. Photo: Conor McKeown

Ayaz Ul Hassan attending the inquest into the death of his wife Nayyab Tariq in Swinford, Co Mayo. Photo: Conor McKeown

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The late Nayyab Tariq. Photo Conor McKeown

The husband of a young woman who died hours after giving birth to their first child has told her inquest of his wife's agonising final moments.

Nayyab Tariq (28) from Ballyhaunis, Co Mayo, died after suffering a cardiac arrest following massive blood loss after the birth of her daughter on March 22, 2020, at Mayo University Hospital, Castlebar.

Mrs Tariq, a gifted academic, was originally from Lahore in Pakistan but moved to Ireland following her marriage in 2017 to her husband, Ayaz Ul Hassan.

On the opening day of her inquest in Mayo, Mr Hassan told how he held his wife’s hand as efforts were made to resuscitate her.

In his statement, he said of his wife's final moments, "it proved impossible to bring her back".

"Never for a moment did I expect that we would go into a hospital to have a baby, and those would be the last moments with my wife.

"Now, we will never be able to hear her voice or see her again. My daughter never got a chance to meet her mother; she will never be able to feel her mother; she will never know the love of her mother. She will only know her mother through photographs.

"She should not be visiting her grave; instead, Nayyab should be playing with baby Nayyab like she always imagined."

Mr Hassan told coroner Pat O'Connor he had witnessed his wife lose what he felt was a substantial amount of blood following the birth.

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Ayaz Ul Hassan attending the inquest into the death of his wife Nayyab Tariq in Swinford, Co Mayo. Photo: Conor McKeown

Ayaz Ul Hassan attending the inquest into the death of his wife Nayyab Tariq in Swinford, Co Mayo. Photo: Conor McKeown

Ayaz Ul Hassan attending the inquest into the death of his wife Nayyab Tariq in Swinford, Co Mayo. Photo: Conor McKeown

He witnessed a "sudden gush" of blood following his daughter’s delivery that seeped onto the bed linen and pooled on the floor on the right side of the bed.

However, subsequent witnesses gave evidence the blood loss suffered by Ms Tariq in the labour ward amounted to 500mls, which was regarded as a mild postpartum haemorrhage.

All medical staff who attended the delivery suite claimed not to have seen the blood on the floor.

The coroner's court heard Ms Tariq had a history of low platelets. Still, her husband told the court they were reassured that the condition was not life-threatening or dangerously low throughout her pregnancy.

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On their penultimate antenatal appointment, they were informed that if her platelets continued to drop, she might need to be brought under the care of a specialist in Galway.

Ms Tariq was by then 37.5 weeks pregnant. An appointment was made for a week later, but she went into labour spontaneously in the meantime.

The couple presented at Mayo University Hospital at 7.30am on March 22, 2020. Mr Hassan said they were both "nervous and excited".

He said his wife complained of intense back pain throughout labour but was smiling, happy and responsive following the delivery of their daughter.

He said he would never forget his wife's smile and the glow in her eyes when he told her their daughter's nose was exactly like hers.

Midwife Mary O'Connor told the inquest she contacted specialist registrar Dr Ike Uzochukwu within three minutes of the baby's delivery.

A decision to transfer Ms Tariq from the labour suite to the operating theatre was made after attempts to deliver the placenta by Ms O'Connor, and Dr Uzochukwu were unsuccessful.

Ms O'Connor told the inquest she believed Ms Tariq was clinically well when she left the labour ward and denied under repeated questioning by the solicitor for the family, Johan Verbruggen, that recorded episodes of tachycardia between 6.50 and 6.52 pm were clinically significant.

The court heard from several witnesses, including consultant obstetrician Dr Maebh Ni Bhuinneain and consultant anaesthetist Dr Aidan O'Shea that following her transfer to theatre to remove the placenta, Ms Tariq's condition severely declined.

A decision was made to place her under general anaesthetic for the manual removal of the placenta as her condition became unstable and she began showing signs of shock.

The court heard that at 7.35pm, the placenta was delivered, yet Ms Tariq’s condition remained unstable.

Dr Ní Bhuinneáin told the inquest she was called by Dr Uzochukwu at 8.20pm and was asked to attend the operating theatre immediately.

She told the coroner that when she arrived at the theatre, she saw the medical team was involved in a coordinated emergency response to postpartum shock.

Ms Tariq was receiving blood transfusions and other medications to stabilise her condition.

She observed that Ms Tariq had a heartrate of 140-150 beats per minute and systolic blood pressure of 75mmHg, which indicated she was in severe shock.

The medical team felt at this point that Ms Tariq's condition did not align with the recorded blood loss, and she must be bleeding internally.

An examination of her uterus found it was empty, and blood loss was minimal.

A decision was made to perform a laparotomy - a procedure to open and examine the inside of the abdominal cavity.

On examination, Dr Ní Bhuinneáin observed multiple blood clots but no immediate source of bleeding. She suctioned 650mls of blood from the peritoneal cavity, and 250mls of blood clots were removed from the pelvis.

She said cumulatively, Ms Tariq had lost 2,275mls of blood at this point - 40pc of her total blood volume.

She said she found abnormal fibroid tissue at the back of the womb that appeared to be responsible for low flow bleeding into the abdominal cavity.

Dr Ní Bhuinneáin said she interpreted the abnormal tissue to be endometriosis-type which usually remains dormant in pregnancy.

She told Mr O'Connor that at 8.58pm, Ms Tariq appeared to be stabilising. However, at 9.11pm she suffered a sudden ventricular fibrillation cardiac arrest.

Repeated attempts to resuscitate Ms Tariq failed, and Dr Ní Bhuinneáin asked that Mr Hassan be called to theatre where she met with him and told him his wife's heart had stopped, and resuscitation was ongoing.

She told Mr O'Connor Mr Hassan remained in the theatre holding his wife's hand while they continued attempts to revive her in the last 20 minutes of her life.

The inquest continues tomorrow.

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