Maternal deaths in hospitals: Faulty drugs could be cause

The directorate of health services has started probing the back to back cases of maternal death after surgical delivery in several hospitals.

The organisation of gynecology and obstetrics specialists is also reviewing the situation. Initially most are speculating that the death might be caused from using faulty drugs before the surgery.

Health minister Samanta Lal Sen told Prothom Alo on Friday, “I’m aware of the matter. The inquiry procedure has been started.”

There have been several incidents of maternal death at hospitals in Chattogram, Sylhet and Cumilla between February and March. Prothom Alo has found news of 16 maternal deaths. These deaths have occurred after the child being delivered through surgery.

The directorate of health services on 28 March formed a ten-membered committee to probe the maternal death cases from hospitals in Chattogram alone.

The committee headed by Chittagong Medical College principal has been asked to submit a report reviewing these deaths with seven working days.

Directorate of the health services director general Abul Bashar Mohammed Khurshid Alam told Prothom Alo that probe committee will soon be formed in the incidents of maternal deaths from other districts as well.

Meanwhile, gynecologists and obstetricians’ organisation Obstetrical and Gynecological Society of Bangladesh (OGSB) has also taken an initiative to review the incidents.

OGSB president professor Farhana Dewan told Prothom Alo, “Hopefully we’ll receive the reports from different districts by Sunday. After reviewing them we might have an idea about the cause of death.”

It has been learnt from talking to OGSB, anesthetist and officials of the directorate of health services that in most of these deaths, patients’ urine discharge starts reducing after a few hours of the surgery, the urine release stops altogether at one point, blood pressure begins to fall, the kidney fails, there’s shortness of breath and the heart fails.

Overall these are the symptoms that have been noticed in the primary observation.

Public health experts and obstetrics specialists say that surgery is required in case of deliveries that are at risk of complications. Surgery in childbirth is a life-saving procedure. There might be some side effects in surgery. However, the incident of maternal death after surgery is strange.

Usually three types of medicines: anesthetics, analgesics and intravenous saline are used in caesarian section or surgical delivery. Plus, antibiotics can be used in some cases. In addition to that some general medicines are used as well.

When consulted pharmacologists, several senior OGSB members and anesthetist they said they are speculating that the recent maternal deaths might have been caused from faults in anesthetics, analgesics or intravenous saline- any of these three.  

Pharmacologist and chairman of the pharmacology department at Bangabandhu Sheikh Mujib Medical University professor Md Sayedur Rahman told Prothom Alo, “Samples of all the medications including anesthetics, analgesics and intravenous saline that have been used needs to be collected from the market and tested at least at three different laboratories. Testing them in any one laboratory won’t yield satisfactory results.”

There’s a crisis of anesthetists in the country. And not every hospitals or clinics have skilled anesthetists. Some have also suggested looking into the matter if there have been a mistake by the anesthetist in any cases. Because allegedly there have been several deaths due to anesthetist’s mistakes in the past two months.

Experts have said that looking into whom of the concerned had what roles in the surgery and how much they have fulfilled that must be a part of the investigation. 

Public health expert Abu Jamil Faisal commented that the entire patient history should be learnt to find out the real facts in case of each death. He told Prothom Alo that there are questions regarding the quality of care provided in the ‘post-operative ward’, after the surgery is done.  

There are no physicians there. Plus, there are many patients under the supervision of just one or two nurses. The fact what care those new mothers received there following surgery needs to be investigated. If the government wants to know the real reasons the bodies should be sent for autopsy, he said.

What type or what quality of anesthetics, analgesic or intravenous saline was used in the hospitals of Chattogram, Sylhet and Cumilla is yet unknown.

Director of the hospital and clinic wing at the directorate of health services, Moinul Ahsan told Prothom Alo Friday that samples have already been collected from several hospitals.

Public health expert Abu Jamil Faisal said, “Maternal death in the hospital while coming to give birth is unacceptable. There’s a risk of more maternal death if the problem is not identified quickly through scientific research.”