Ana Geanina SIRGHI-MARIN · Prevention of Future Deaths report

On 2 August 2016, I commenced an investigation into the death of Ana Geanina Sirghi-Marin, who died on 29 July 2016, aged 36 years. The investigation concluded at the end of the inquest on 5 January 2017. I made a determination at inquest as follows.

Ana Sirghi-Marin died because of a naturally occurring uterine infection, when she was sixteen weeks pregnant. She had become pregnant by in vitro fertilisation (IVF) and had undergone an amniocentesis at approximately 1pm on 27 July 2016.

I recorded a medical cause of death of:

1a Escherichia coli sepsis
1b chorioamnionitis
1c second trimester pregnancy.

It appears that the amniotic E coli pre-dated the amniocentesis, as it was later determined to be present in the amniotic fluid drawn off that day.

It is unclear whether conception by IVF played any part in the infective process.

The amniotic fluid drawn off at amniocentesis two days before death was neither purulent nor blood stained, but was discoloured dark yellow.

Given the rarity of such non blood stained discolouration, I heard evidence that it would be a wise precaution in this situation always to send a sample for immediate microbiological analysis, and quickly to follow up the result.

I say always because, at the time of the amniocentesis, there was no fever or other indicator of infection, yet when Ms Sirghi-Marin presented at the emergency unit the following afternoon she was very unwell, and she died the next morning.

Such action would not have changed the outcome in this instance, because presentation to the emergency unit took place approximately 26 hours after the amniocentesis. However, it might in another case. And given the rarity of such non blood stained discoloured amniotic fluid, a guideline that this action is necessary does not seem onerous.