The jury in the inquest into the death of a pregnant mother-of-two, who was maintained on life support for 24 days after she was declared brain dead, has returned an open verdict.

Earlier, a consultant neurologist told the inquest into the death of the 26-year-old that she had an exceedingly large cyst on the left side of her brain.

He said when she arrived at Beaumont Hospital after becoming unconscious on the night of 29 November 2014, the signs were that she was extremely unlikely to survive.           

The consultant, who examined her in Midland Regional Hospital in Mullingar earlier that day, told the inquest that the young woman was in no obvious distress and she had no concern that she was suffering from anything more than very severe morning sickness.

Consultant neurologist Stephen McNally said a CT scan carried out on the young woman after she had become unconscious showed a very large cyst.

Mr McNally said this would have caused a build-up of fluid, a rapid rise in pressure and deprived the brain of oxygen.

It is impossible to diagnose the type of cyst due to the type of scan and the condition of the woman's body at the post-mortem examination, he said. 

He added it was most likely she was clinically dead when she arrived at Beaumont Hospital but that could not be proved without further tests and said it was unbelievably rare to bring someone back from that situation.

Mr McNally said medical staff in Beaumont Hospital treating the woman were unsure about the law in relation to her foetus and they did not get strong advice.

He said on the available evidence they felt they had a duty of care to the foetus and that is why they maintained the woman on a ventilator while they requested legal clarification.

The consultant who examined her in Mullingar the previous day told the inquest she was in no obvious distress.

Hilary Cronin said in the early afternoon of 29 November, the woman was lying flat on her bed with a magazine in her hand and looked well.

She said she examined her and spoke to her and said her firm view at that time was that she had hyperemesis gravidarum, or severe morning sickness.

There was no evidence of any pressure build-up in her brain and she did not think something more sinister was going on, Ms Cronin said. 

The woman was at the centre of High Court proceedings last December into whether or not her life support treatment could be withdrawn.

The woman was around 15 weeks pregnant when she was declared brain dead by doctors. 

However, her family were told her life support could not be turned off due to the Eighth Amendment to the Constitution, which protects the right to life of the unborn.

A three-judge division of the High Court ruled last St Stephen's Day that life support treatment could be withdrawn as there was no genuine prospect of her baby being born alive.  

Woman had complained of headaches

Earlier, the inquest heard the woman had been complaining of headaches from early September 2014 but it was not until 29 November that doctors in Midland Regional Hospital in Mullingar discovered she had a cyst on her brain.   

She had been brought to hospital two days earlier, crying about the pain and pressure in her head.

She was declared brain dead at Beaumont Hospital on 3 December 2014 and her life support machine was turned off on 27 December following the High Court's decision.

Her GP, Rosemary Cunningham O'Leary, told the inquest at Mullingar Courthouse that the woman first complained of headaches on 9 September 2014.   

She had been diagnosed with severe morning sickness and a urinary tract infection. 

In early November that year Dr O'Leary said the woman was suffering from severe headaches occurring once daily.    

Dr O'Leary said she was not aware that doctors in Mullingar hospital discovered on 29 November 2014 that she had a cyst on her brain until sometime afterwards

Dr O'Leary said headaches would be a common side effect of excessive vomiting.

In her evidence, Dr O'Leary said it would have been totally unexpected that the cause of the woman's vomiting would have been anything else other than morning sickness complicated by a urinary tract infection.

The woman's father told the inquest that his daughter had been complaining constantly of headaches since September 2014.  

He said she had been suffering from headaches, dizziness and vision impairment and had been admitted to the Midland Regional Hospital in Mullingar on three occasions. 

She had been put on drips twice, he said, and her foetus had been scanned. But he said she had not been scanned for the problems she was complaining about.

He added that on 27 November her headaches were so bad that she asked her aunt to bring her to hospital.

The inquest heard the young woman texted her aunt saying she thought she was on the way out. She was crying about the terrible pain and pressure in her head.

Her father said the following evening when he saw her in hospital, she was unable to talk very much and was holding her head and covering her left eye and was complaining about headaches.  

He said this was the last time he saw his daughter alive.

He spoke to his daughter on 29 November and she said that the CT scan she was expecting to have that day had been postponed until the following Monday.  

Lawyers for the hospital said a decision was taken that the scan was not required on that day.

That night her father said he got a call from the hospital who told him his daughter was unresponsive.  

She was moved to Beaumont Hospital where he was told that she had passed away. He said her surgeon said she was already "gone" by the time she arrived in Beaumont.

He said the surgeon told the family the woman was put on life support because her foetus had a heartbeat.  

He said the surgeon told him it was due to the Eighth Amendment of the Constitution. 

He said the surgeon said his hands were tied and it would be against the law to turn off the machine.

At that stage, he and the woman's fiancé decided to seek legal advice about mounting a legal challenge.

The inquest heard that after a brain stem test on 3 December, the woman was declared to be dead.

The young woman's aunt told the inquest that her niece was very distraught before she brought her to hospital on 27 November last year.  

She said she was sitting at the kitchen table talking about the pain and pressure in her head and she was very unsteady on her feet.  

She had texted her asking what she was going to do as she was in so much pain she thought she was on the way out, the inquest heard.

She said in hospital, her niece was not able to talk. She was staggering and crying with pain.    

The aunt said she left and was texting her the next day. A CT scan had been mentioned in her niece's texts.

She added they were called to hospital on the night of 29 November and told the young woman had fallen and had later been found unresponsive in bed.  

Doctors told them that night that they had found a mass in her brain. She said they were then allowed to see the young woman.

She said she was on a ventilator and she was cold. Her aunt said she believed her niece was not alive and was gone by that stage.

She was then transferred to Beaumont Hospital. She said doctors carried out a procedure to relieve pressure on her brain.  

But she said the surgeon told them she had not responded and there was no hope for her. 

Senior Counsel Adrienne Egan said the young woman had told doctors on that day that she was pain free.  

She had also been sleeping well.  

Her aunt rejected a suggestion that she had been sitting up in bed, reading a magazine with the television on.  

Her aunt told the inquest she was so sick she would not have been capable of doing that but accepted that she had not seen her that day.

A very good friend of the family told the court that she had seen the young woman in hospital on the evening of 28 November. She said she was holding her head.   

She said in hindsight she wished she had called someone but she trusted that she was being looked after by professionals.

She also said that when she saw her on 29 November after she had become unresponsive in hospital, her gut feeling was that she was already dead.

The jury has now retired to consider its verdict.The coroner told them the cause of the young woman's death was fluid on the brain secondary to a large cyst.

He said the official time of death was on 3 December 2014 when the main brain stem function test was carried out in Beaumont Hospital in Dublin.

The coroner said if they felt something more could have been done to save the woman's life then they should return a verdict of death by medical misadventure.

If they felt the medical staff had done all they could under the circumstances they should return a verdict of death by natural causes or if they could not decide they should return an open verdict, he said. 

CREDIT:http://www.rte.ie/news/2015/0922/729494-inquest-pregnant-unborn/