PMC committee recommends measures to curb fatalities.
A woman in her mid-20’s delivered a premature baby at a private hospital in Kondhwa. She was discharged on the grounds that there were no complications. However, she died within three days and the death certificate issued by another local doctor made no mention of her pregnancy.
Had it not been for a few alert auxiliary nursing midwives (ANMs), this case would have gone unnoticed and like many others over the last one year.
Taking into account the rising number of maternal deaths recorded with the Pune Municipal Corporation (PMC), the civic officials’ expert committee has recommended a slew of measures to bring down these numbers including tracking every registered pregnancy right from ante-natal period till post-birth of child.
Dr Anjali Sabne, deputy medical officer of health and chief of family welfare bureau, PMC said, “Of the 64 maternal deaths recorded in the city from April 2012 to April 2013, the maximum cases i.e. 15 deaths pertained to pregnancy-induced hypertension. Nearly three-fourth of the cases occurred during the ante-natal (before birth of child) period and hence it came to our notice that regular follow-ups and tracking the mother’s health is most important. However, another problem is late registration of women with clinics and irregular follow-ups. Even when women are told that their pregnancy is high-risk, they don’t bother to follow up.
That’s why we have proposed that at the time of registration, a copy of the woman’s Aadhar Card or ration card be obtained so that if she fails to turn up for follow-ups, an ANM can visit her residence and find out the reason.”
Special focus would be on high-risk pregnancies especially in women already having a history of high-blood pressure, anemia, twin pregnancies, and young age.
While the maternity mortality ratio (MMR) hovers of the city hover around 22 to 24 per 1 lakh live births, which is already much better than the state average, the PMC officials hope to bring this number down even further by next year.
Civic officials said that another important fact was that most of the deceased women hailed from rural areas and that the time lost in transferring women from rural areas to tertiary care centres was crucial. “That’s why we have proposed that when a pregnant women is being referred to the city, she should be shifted in an ambulance and medical personnel should accompany her. There should be a proper chain of referral and all complicated cases to be directly referred to tertiary care centres without loss of time,” added Sabne.
The committee recommended autopsy of all pregnancy deaths to find out the cause and nail the negligence if any.
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