A mother-to-be and her unborn baby died after an epileptic seizure, and an inquest has heard she was not informed of the risks associated with her condition. Megan Gardiner, 25, was 17 weeks pregnant when she and her unborn son were discovered deceased in her bedroom by her mother.
Failures in Care
The inquest in Pontypridd heard that Ms Gardiner had 'one of the most volatile' types of epilepsy and was not properly advised about her medication during pregnancy. Her mother, Alison Woolcock, found Ms Gardiner having fallen between her bed and the wall in their family home in Barry, South Wales. The medical cause of death was later determined as Sudden Unexpected Death in Epilepsy (SUDEP) in June 2022.
Epilepsy specialist Kim Morley, a registered midwife, nurse prescriber, and advanced clinical practitioner, stated there had been a series of failures in Ms Gardiner's care before her death. 'With the knowledge of her seizure description and medical history, Megan had probably one of the most volatile types of epilepsy to present in pregnancy,' Ms Morley said. She added that Ms Gardiner's seizures 'had never been controlled by her epilepsy medicines'.
High Risk of SUDEP
Ms Morley described Ms Gardiner's condition as 'probably the highest in terms of the risk of SUDEP'. She emphasised the importance of informing patients: 'Without being informed of this risk, without the knowledge, how could you counsel somebody accurately? It is a really hard conversation, I absolutely acknowledge that, but in order that women are making an informed decision, they need to have all the potential knowledge of what that decision could do.'
She explained that if women are not given all the information, they may make decisions based on online information about potential effects of medicines on a baby. 'As a practitioner you have this opportunity, this window, to actually individually counsel them about their potential risk and that's what I felt was missing in terms of Megan's care,' she said.
Medication Advice Questioned
The would-be mother had been advised to decrease Zonisamide without titrating in another medication, a decision Ms Morley said she would not have made. 'I do not know any neurologist that would have made that decision... I'd have been terrified this woman could die,' she said.
The inquest is investigating what advice and care Ms Gardiner was given during her pregnancy by medical professionals and what medication she was on. Ms Woolcock described her daughter, who suffered from epilepsy since age 13, as 'beautiful' and having a 'wonderfully sarcastic sense of humour'. She said: 'Megan was ambitious. An ultimate goal was to own her own business one day doing make-up.'
Family's Concerns
Ms Woolcock told the hearing that the risks of SUDEP were never directly brought up to her or her daughter, but instead were discussed as a generalised risk. She said that although medics discussed terminating the pregnancy, Ms Gardiner never considered it. The hearing was told the would-be mother was also at risk from 'sleep seizures', but the family had not been made aware of this. Ms Woolcock said if they had known, she would have co-slept with her daughter.
Speaking ahead of the inquest, Ms Gardiner's family raised concerns about her epilepsy care before and during pregnancy. The hearing was told medics were looking at new medications and she chose not to take sodium valproate despite doctors recommending it when other medications had not worked. The inquest heard sodium valproate was dangerous for babies, but Ms Gardiner may not have understood it would only have been a temporary treatment to halt seizures.
Second Loss of a Child
After her death, Ms Woolcock paid tribute to her 'perfect' daughter, saying she was 'devastated' by the loss. It was the second loss of a child for Ms Woolcock and her partner Robert, after their middle daughter Ellie died in 2001 of sudden infant death syndrome shortly before her second birthday. 'We've already been through this once and we're going through it again,' said Ms Woolcock. 'It's just devastating.' She added: 'Meg really wanted to be a parent. She was happy about being pregnant.'
The hearing, before coroner Kerrie Burge, continues.
