A mother who died after giving birth to twins was not given blood pressure medication despite a "catastrophic" reading and a family history of hypertension, an inquest has heard.
Corrina Medway, 33, suffered a stroke and died after giving birth to the twins at Calvary Hospital on May 19, 2011, and an inquest is now looking at whether her case was mishandled by medical staff.
Obstetrician Dr Andrew Foote was repeatedly questioned in the ACT Coroner's Court on Tuesday about the failure to give Mrs Medway anti-hypertension medication to lower her blood pressure before her death.
Mrs Medway had hypertension, or abnormally high blood pressure, days before to her admission to Calvary. She also had a high-risk family history on her mother's side.
Mrs Medway had been to Yass District Hospital on May 13, where elevated blood pressure was recorded, prompting Dr Foote to have her placed on the drug Labetalol.
But he asked for the drug to be withheld three days later, telling the inquest nurses had led him to believe it was working too well and her blood pressure was now too low.
Things quickly began to go wrong for Mrs Medway.
Her blood pressure began to fluctuate, and midwives said they recorded elevated readings, which they passed on to Dr Foote.
Mrs Medway reported being in significant and constant pain and considerable distress the evening before the births.
One blood pressure reading was catastrophic and suggested that she would die without intervention, the inquest heard.
Yet the rapidly acting anti-hypertension drugs that were available were not used.
Mrs Medway suffered a stroke and died five hours after giving birth to the twins on May 19, 2011.
Dr Foote claimed on Tuesday he had never been told of the catastrophic blood pressure reading, saying he'd only received information suggesting her blood pressure was stable.
"It would have been an absolute game-changer, which I was never told," he said.He said he'd also asked to be kept informed by staff, but didn't receive a call until later in the night from a registrar.
Dr Foote said he wasn't told of the catastrophic reading until the next day, during a conversation with the registrar.
Counsel Assisting Amanda Tonkin accused Dr Foote of making that evidence up, asking why he had not mentioned the conversation in his letter to the coroner, or instructed his lawyers to question the registrar about it earlier in proceedings.
The registrar had said in a statement that he communicated all of Mrs Medway's observations to Dr Foote, but later said he couldn't remember the precise details of what he'd passed on.
Dr Foote also denied the evidence of two Calvary midwives who said they'd told him of Mrs Medway's elevated blood pressure.
He also said he was not made aware of her family history of hypertension.
Dr Foote said he was not told Mrs Medway had been observed earlier that month with swelling of the hands and lower legs, and pins and needles in her arms, all symptoms of preeclampsia, a pregnancy disorder.
When asked why he didn't give Mrs Medway blood pressure medication, he said her condition was still unclear, and that, lacking a proper diagnosis and blood test results, such a treatment could have been dangerous and put her into shock.
"I think it was a very confusing picture and we were all concerned about giving anti-hypertensives if it was the wrong diagnosis," he said.
He said her pain could have been the reason for her high blood pressure, and told the inquest painkillers were used to try to stabilise it.
Dr Foote said there were two other doctors involved who also didn't decide to use the anti-hypertensive medication.
Coroner Margaret Hunter expressed her sympathies to the family and thanked them for attending the inquest proceedings. She is expected to hand down her findings in early December.