Maternal mortality: Covid was top killer in 2020-21, shows BMC data

A pregnant woman waits outside a Covid care centre, in Dahisar, on April 19, 2021. Pic/Satej Shinde

Postpartum haemorrhage and sepsis accounted for most maternal mortalities in the city until 2019, but since the outbreak of novel Coronavirus in March 2020, the respiratory disease became the top reason behind the deaths. In 2021, Covid-19 caused one in every four maternal deaths. According to the experts, delay in medical attention was the main factor in Covid-related fatalities among pregnant women. They listed out precautionary measures to avoid further fatalities.

Dr Niranjan Chavan, president of Mumbai Obstetric & Gynaecological Society, said "The delay in seeking treatment and late referral leads to the death of 89 per cent of women. During Covid-19, we didn't have the rapid antigen test initially , so we depended on RT-PCR report that took time. We have also observed that 83 per cent of the patients were referred from other hospitals. Lack of management also contributed to the deaths.

"Women need to be more cautious during pregnancy, and seek immediate medical intervention if they notice any symptoms. Doctors should also ensure that there isn't any delay in referral or treatment. Most importantly, pregnant women must get vaccinated against Covid-19," Dr Chavan added.

According to the BMC's data, 259 pregnant women died in 2019, with 32 succumbing to postpartum haemorrhage, 28 to sepsis, 17 to TB, etc. In 2020, of the 198 maternal deaths, 29 were caused by Covid-19, 18 due to postpartum haemorrhage, 18 due to sepsis and 10 due to ARDS (acute respiratory distress syndrome). Of the 190 deaths in 2021, 43 were caused by Covid-19, 22 by sepsis and 21 by postpartum haemorrhage.

"If pregnant women get Covid-19, the chances of severity of the disease are more because of low immunity. Not only death, Covid-19 has also caused preterm delivery and miscarriage. During Covid-19, we also observed a delay in hospitalisation of pregnant women," said Dr Ashok Anand, head of Obstetrics & Gynaecology Department at JJ Hospital. "Overall, proper antenatal care is needed to reduce maternal mortality, as it will help early detection of anaemia, pregnancy-induced hypertension or diabetes," he added.

Sion hospital conducted a research on maternal mortality, which showed that 390 Covid-positive pregnant women were hospitalised between April 1, 2020, and July 31, 2021. Of them, 17 died during the treatment. "While 89 per cent of the deceased women were in the 20-30 years age group, 55 per cent had fever, cough and breathing problems. Around 64 per cent of women died after five days of diagnosis, while 45 per cent of women lost their lives within five days of delivery," the study shows.

Dr Mangla Gomare, BMC's executive health officer, said, "Not just maternal mortality, but Covid-19 generally caused more deaths in 2021. We have to see whether all maternal deaths were caused by Covid-19 or there were other reasons. It has also been observed that maternal mortality in Mumbai is low. Many patients come from other districts for tertiary care."

43
No of pregnant women killed by Covid in 2021