Jaipur: A Rajasthan health department audit of 27 maternal deaths reported between Sept 6 and 17 found serious gaps in monitoring, delayed referrals, transport and management of high-risk pregnancies, particularly in rural areas.The audit found that several women developed complications at peripheral facilities and were referred to higher centres after their condition deteriorated. At least three women died while being shifted from rural health facilities to higher centres (in transit).On Sept 6, Maya, a resident of Kathumar in Alwar district, developed postpartum haemorrhage at CHC Kathumar. As her condition worsened, she was referred to a higher centre but died in transit. Two days later, Priyanka, a resident of Jaimalsar in Bikaner district, also developed postpartum haemorrhage and died while being shifted to a higher centre. On Sept 15, Babli developed viral pneumonitis with acute respiratory failure, along with pregnancy-induced hypertension, and died while being referred from the district hospital in Dungarpur to a higher centre.Postpartum haemorrhage was the leading cause of these deaths during the audit period, claiming seven lives. Hypertensive disorders of pregnancy caused five deaths, while embolism accounted for four. Three women died due to cardiac arrest, two due to septic shock and two due to pneumonitis. Four other deaths were attributed to septic abortion, anuria and enteric fever.Udaipur’s Pannadhay Hospital emerged as a major area of concern, with five maternal deaths reported within seven days. On Sept 17, Seena died of antepartum eclampsia, ICU complications and cardiopulmonary arrest at the hospital. On Sept 15, two women, Suman and Jamna, died at Pannadhay Hospital after being brought from Sirohi and Rajsamand districts for treatment. Suman died of cardiac arrest with septic shock and severe pre-eclampsia, while Jamna died of acute respiratory embolism.Two women died during treatment at Pannadhay Hospital. Shanti Katara, brought from Banswara, died on Sept 12. An audit attributed her death to traumatic postpartum haemorrhage leading to acute renal failure with postpartum disseminated intravascular coagulation. Bati, a Madhya Pradesh resident, died from HELLP syndrome and enteric fever.The findings have highlighted the need for stronger antenatal monitoring, timely detection of high-risk pregnancies, better stabilisation at first-contact facilities and faster referral systems for pregnant women in rural Rajasthan.
