BENGALURU: Karnataka recorded 348 maternal deaths till November this year, with 217 cases reported in just four months, from August to November. Of these, 179 were in government hospitals and 38 in private facilities.
The data shows that between August and November, over 50 maternal deaths were reported each month in the state. While Ringer’s Lactate, an IV fluid, came under scrutiny following maternal deaths in Ballari, experts stressed that other factors, such as postpartum haemorrhage (excessive bleeding following delivery), lack of supportive antibiotics, trained medical professionals and adequate care for postpartum infections, also need urgent attention.
Dr Ramesh GH, Head of Emergency and Critical Care at BMCRI, said the role of Ringer’s Lactate should not be viewed in isolation, but should be considered in a broader context. A detailed investigation into the overall treatment process and underlying medical conditions is necessary to pinpoint the real causes of the fatalities.
The suggestion that IV fluids like Ringer’s Lactate can be directly blamed for maternal deaths fails to consider the complexities of medical cases, experts said and explained that a death would typically be within hours due to anaphylaxis (allergic reaction) if Ringer’s Lactate were substandard or improperly administered.
‘Pregnant women should be monitored to find risks’
Explaining major fatal complications, Dr Ramesh highlighted amniotic fluid embolism (AFE), which occurs when amniotic fluid enters the mother’s bloodstream, triggering a severe allergic-like reaction.
This event can lead to sudden cardiovascular collapse, respiratory distress and disseminated intravascular coagulation (DIC) that affects the blood’s ability to clot. Moreover, postpartum haemorrhage remains a major reason behind maternal deaths, he added.
Doctors also suggested that analysis is needed to determine whether the patient was a booked or unbooked case (those who received regular antenatal care are categorised as booked, while those who did not are unbooked), whether they were under follow-up until delivery and if the delivery was normal or a C-section.
Maternal deaths occurring shortly after delivery may point to causes like anaphylaxis, AFE or PPH, while deaths after a few days mostly indicate complications linked to pre-existing conditions.
Experts said maternal deaths in government hospitals are common among women from poor backgrounds and those coming from district centres. Many delay getting care because they have to travel, which leads to serious complications. Most of these deaths are also seen in women having their third child or more.
Explaining the situation at government hospitals, Dr Savita C, Medical Superintendent at Vani Vilas Hospital, highlighted that women are advised to visit three times a week for antenatal or pregnancy-related care, but many do not show up. Moreover, most maternal deaths occur due to anaemia, but the condition remains untreated because women do not seek medical care for iron supplements or injections.
Regular monitoring of pregnant women through prenatal visits can identify risks and early intervention can prevent complications that could lead to death, she said.
A public health expert, however, said negligence and insufficient training of healthcare professionals, specifically in government hospitals, have been a significant factor contributing to maternal deaths. Inadequate training and lack of experience among healthcare workers can lead to delays in recognising and managing complications during pregnancy and childbirth, resulting in preventable fatalities.