Doctors "failed to realise" that a first-time mother's pregnancy had become "much higher risk" because crucial warning signs were not properly highlighted in her medical records, an inquiry has heard.

Nicola McCormick was obese and had experienced repeated episodes of bleeding and reduced foetal movement, but was wrongly downgraded from a high to low risk patient weeks before she went into labour.

Her daughter, Ellie McCormick, had to be resuscitated after being born "floppy" with "no signs of life" at Wishaw General hospital on March 4 2019 following an emergency caesarean.

She had suffered severe brain damage and multi-organ failure due to oxygen deprivation, and was just five hours old when her life support was switched off.

A fatal accident inquiry at Glasgow Sheriff Court was told that Ms McCormick, who was 20 and lived with her parents in Uddingston, should have been booked for an induction of labour "no later" than her due date of February 26.

Had this occurred, she would have been in hospital for the duration of the birth with Ellie's foetal heartbeat "continuously" monitored.

In the event, Ms McCormick had been in labour for more than nine hours by the time she was admitted to hospital at 8.29pm on March 4.

A midwife raised the alarm after detecting a dangerously low foetal heartbeat, and Ms McCormick was rushed into theatre for an emergency C-section.

Dr Rhona Hughes, a retired consultant obstetrician who gave evidence as an expert witness, told the FAI that Ellie might have survived had there been different guidelines in place in relation to the dangers of bleeding late in pregnancy, or had her medical history been more obvious in computer records.

The inquiry has heard that Ms McCormick attended maternity triage four times during her pregnancy - at 17 weeks and 34 weeks for bleeding, and at 26 weeks and 36 weeks for reduced foetal movement.

However, her midwife was replaced two weeks before her due date as the result of a new maternity scheme which was being piloted in Lanarkshire at the time.

The handover between her previous and new midwife - who she met for the first time at an antenatal clinic in Hamilton on February 13 2019 - was described as "non-existent".

In addition, her consultant obstetrician - who she also saw for the first time during the same appointment - told the inquiry that she "didn't know" about the episodes of bleeding and reduced foetal movement, the most recent of which had occurred 10 days prior.

Following a review that day, Ms McCormick was discharged onto the 'green' - low-risk - pathway, having previously been graded red due to a BMI in excess of 35.

The Herald: Dr Hughes speaking to media following the delivery of Gordon Brown's eldest son, John, in Edinburgh in 2003Dr Hughes speaking to media following the delivery of Gordon Brown's eldest son, John, in Edinburgh in 2003 (Image: PA)

In a report prepared for the inquiry, Dr Hughes wrote: "My main criticism is that the clinicians failed to act on and realise that Nicola's level of risk had become much higher than it was at the beginning of the pregnancy."

Asked what she would have done differently, she said: "I would have advised induction of labour by 40 weeks...[that it was] not safer to go any further.

"I would have suggested that to Nicola as an option."

Dr Hughes said that the combination of bleeding, reduced foetal movement, and obesity put Ms McCormick at increased risk of stillbirth.

Bleeding after 24 weeks in pregnancy - known as antepartum haemorrhage (APH) - is a leading cause of death for mothers and infants.

According the the Royal College of Obstetrics and Gynaecology, any mother experiencing this "should be reclassified as high risk including where bleeding is unexplained" - as it was in Ms McCormick's case.

Dr Hughes, a former clinical director of obstetrics at NHS Lothian who delivered then-Chancellor Gordon Brown's son, John, at Edinburgh Royal Infirmary in 2003, said that Ellie's life might have been saved had this advice been included within NHS Lanarkshire guidelines at the time.

She added that clinicians used to know when they were encountering a patient who had visited hospital multiple times during their pregnancy because their case file would be "much thicker than you'd expect".

The shift from paper-based to electronic records meant this was "less obvious", said Dr Hughes.

She said all of these episodes and risk factors should have been clearly listed on "a sheet at the front of the notes" in Ms McCormick's medical record so that it was the first thing anyone logging on would see.

The death of Ellie McCormick is one of three baby deaths in Lanarkshire being investigated as part of the FAI, along with those of Leo Lamont and Mirabelle Bosch.

The Crown Office said all three infants died in circumstances which give rise to "serious public concern".

The inquiry continues.