THE safety of some pregnant women and their babies may be put at risk by a lack of operating theatres at a Gwent hospital's main delivery unit, says a hard-hitting report.

The "totally unsuitable" delivery room three at Newport's Royal Gwent Hospital is increasingly used as an emergency theatre for Caesarean sections.

Gwent Healthcare Trust has stressed that the overwhelming majority of deliveries occur without problems. But the report - to go before the trust board next Wednesday - highlights two recent, worrying cases:

l In February, a woman needing an emergency Caesarean was on the operating table in the unit's only theatre, but had to be moved to room three for surgery because a more urgent case came in.

l In April, an emergency Caesarean was delayed because room three was occupied by a woman needing high-dependency care. At the same time, three other women also needed such care, just one step below intensive care, and because of a lack of high- dependency beds in the unit, had to be treated in the corridor.

The cases, state the report, are "undesirable examples of compromise" that are required in order to manage capacity at the unit.

It proposes creating a new double theatre suite, two high-dependency beds and two more delivery rooms at a cost of more than £3 million, with extra annual running costs of £250,000.

The Royal Gwent's main delivery unit has come under increasing pressure as the number of births there has risen. The transfer of higher-risk cases from Caerphilly District Miners Hospital in February has upped the number of births. During February-June, 135 more babies were delivered at the Royal Gwent than during the same period in 2001.

The growing demand for planned Caesarean sections has also led, says the report, to the unit's single theatre being used more often, which has had the knock-on effect of increasing the number of occasions that delivery room three has had to be used as an emergency theatre.

It lists 27 occasions since the start of 2001 when deliveries were delayed by the lack of a second theatre or lack of obstetric beds.

But it points out that it is not just numbers that are significant, but the circumstances at the time and the fact room three is only used as an operating theatre if a "crash", or emergency, Caesarean is needed.

"Clinicians are understandably reluctant to operate within this room, except when there is absolutely no alternative, and immediate action is required because the life of a mother or baby is at risk," states the report.

"This reluctance is based on issues of clinical risk, infection control, insufficient space, patient privacy, and an inappropriate environment.

"Clinical practice at the Royal Gwent Hosp-ital is being adversely compromised because room three is used as a theatre only when dire urgency requires it.

"Therefore, many women and their babies with foetal distress are put at risk because they are kept waiting as a result of justified concerns over using room three. The delay in delivering a hypoxic (low levels of oxygen in the blood) baby can lead to permanent brain damage."

The report forms a strategic outline case that requires trust board approval next Wednesday. If that is forthcoming, it will go to the National Assembly, which will decide whether the trust can go ahead and put together a business case for change.

PICTURE: Miguel and Kate Garcia, with their daughter Consuela born at the Royal Gwent, say they had no inkling of any problems. Mr Garcia said: "Personally we found it all very good."