No autopsy in maternal deaths
■ Examination must to reduce death rate, say city doctors
In what is considered to be a blatant negligence on the part of the health departments of AP and TS, no autopsy is conducted following maternal deaths, a large number of which are preventable.
All maternal deaths in government and private hospitals are branded as natural deaths and the bodies are not sent to mortuaries for postmortem examination.
Forensic doctors say that autopsies will reveal not only medical negligence, if any, but also underlying diseases or pathologies in different organs and correlate clinico pathology in maternal deaths. In the recent case of a woman dying in childbirth at Niloufer Hospital, no autopsy was conducted. Nor does the inquiry committee include forensic doctors.
Dr R. Sudha, associate professor of forensic medicine in Osmania Medical College, says that institutional deliveries are advocated to bring down the maternal mortality rate, “but it’s shocking that huge numbers of deaths are reported from maternity hospitals in the city every month. My paper on maternal death autopsy is to be published in ‘Recent advances in forensic medicine’.”
She says that only if there is an allegation of negligence or foul play leading to a criminal case, is an autopsy conducted. “But pathological autopsy is essential and it is a useful tool in reducing the maternal mortality rate. Each maternal death is a tragedy but the bigger tragedy is failing to learn lessons from the preventable maternal deaths,” she says.
In what is considered to be blatant negligence on the part of the health departments of AP and TS, no autopsy is conducted following maternal deaths, a large number of which are preventable. Dr R. Sudha, associate professor of forensic medicine in Osmania Medical College, said a whopping 80 per cent of maternal deaths are preventable.
“The Niloufer committee should have had a forensic doctor when it was formed to determine the cause of death. Government should bring in compulsory autopsy for all maternal deaths like in the United Kingdom. Following the determination of cause of death, suggestions are given to health authorities to rectify,” she said. “There should be a regular audit report of all tertiary care hospitals along with autopsy and other histopathology, toxicology, serology and microbiology studies. Deaths due to haemorrhage and sepsis are complication of perforation of the uterus. While perforation is a recognised complication of any procedure involving instrumentation of uterus, death due to sepsis or haemorrhage should not occur and it strongly suggests the possibility of medical negligence,” Dr Sudha says.
The resident medical officer of Petlaburz Maternity Hospital, Dr G. Sridevi, confirmed that “we don’t send all bodies for autopsy. Whenever relatives of patients raise litigation we send them. Sometimes patients’ kin refuse an autopsy. Ours is a tertiary hospital and we get cases in serious condition and like in any tertiary hospital, deaths occur”. Boasts by politicians about how women are at the centre of their concern seem like just so much rhetoric when so many maternal deaths can be avoided.