Obstetric complications: awaiting assessment
The continuous occurrence of obstetric complications in recent times has made pregnant women and the whole society worried.
Speaking to Tuoi Tre, Mr. Nguyen Duy Khe, Director of the Department of Maternal and Child Health, Ministry of Health said: The final conclusion on the cause of maternal death in the past is still waiting for the results of the forensic examination. So far, we have only received the forensic examination reports of two cases of accidents in Ho Chi Minh City and Quang Nam. The leaders of the Ministry of Health have requested that in all cases of accidents that have occurred, in addition to causes such as amniotic fluid embolism, we must seriously consider whether there are any other causes! Is it due to a lack of staff, unreasonable organization and arrangement of human resources, or errors in compliance with professional procedures, hospital regulations, diagnosis, prognosis, or is the cause related to the qualifications of staff so that a synchronous solution can be found?
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The joy of parents welcoming their children on the day of discharge from the hospital - Photo: Quang Dinh |
| Strive for 100% of district hospitals to be able to perform cesarean sections. To reduce obstetric complications, according to Mr. Nguyen Duy Khe, it is necessary to synchronously deploy solutions: consolidate and perfect the organization system of the reproductive health care network/maternal and child health from the central to the grassroots level; improve professional capacity, arrange enough staff for obstetrics and pediatrics departments of provincial and district general hospitals and ensure necessary equipment for emergency resuscitation. Strive for 100% of district hospitals (except district hospitals near provincial hospitals within a distance of less than 20km or accessible to provincial hospitals within 60 minutes) to be able to perform cesarean sections and blood transfusions. |
* Sir, in the recent accident cases that have been reported to the Ministry of Health, which cases do you think were caused by errors in procedures, diagnosis, prognosis, weak staff...?
- We are waiting for reports from the inspection teams. Currently, the teams from Tu Du Hospital and the Central Maternity Hospital are going to Quang Ngai, Hung Yen and Dong Nai. The Ministry of Health's stance is to not cover up, and to strictly handle any errors that are discovered. Obstetric complications are still a big challenge for doctors because obstetric complications often occur quickly, develop abnormally and are very difficult to predict. According to data from the World Health Organization, each year there are 10 million cases of obstetric complications out of a total of 80 million births, and each day there are 1,000 maternal deaths. Maternal mortality in Vietnam (69/100,000 live births) is lower than in some countries in the region such as Indonesia, the Philippines, Myanmar, but higher than Thailand, Malaysia, and Singapore.
* In the reports of obstetric complications that have occurred recently, many cases clearly show delays. Does the Ministry of Health see this?
- In addition to reviewing deaths according to hospital regulations, the Ministry of Health is directing the implementation of maternal death assessment activities. This activity has been previously implemented in a number of localities. Since 2010, the Ministry of Health has directed and requested health departments to promote and expand the implementation of this activity nationwide. This activity aims to gain professional experience, based on a detailed review of the process of diagnosis, monitoring, and emergency care for pregnant women, thereby drawing experience to see where the complications come from, whether they are related to expertise or due to other causes, helping doctors improve the quality of treatment and emergency care, avoiding similar complications.
* There is an opinion that there is a serious shortage of obstetricians. Do you think the current system is sufficient to handle over 1 million births each year and many other obstetric and gynecological services?
- In the field of maternal and child health care, there is not only a shortage of pediatricians but also of obstetricians, not only at the district level but also at the provincial level. The Ministry of Health is developing a network plan for obstetrics and pediatrics and a master plan for medical human resources, including human resources in obstetrics and gynecology and pediatrics.
* All recent cases of maternal deaths due to obstetric complications are in the plains provinces and cities with human resources. Does the Department have any reports analyzing how many cases of maternal deaths due to obstetric complications each year are in mountainous and remote areas, and how many are in the plains?
- According to the reported data on obstetric complications and maternal deaths, although they mainly occur in mountainous provinces/areas, there are also many maternal deaths occurring in the plains provinces, including at higher-level medical facilities. To have relatively accurate data on maternal deaths, it is necessary to rely on research and surveys, which can only be done periodically every 5-10 years because organizing surveys is very expensive. The Ministry of Health really wants to have representative data for each ecological region and each locality, but to do so, the sample size will be very large, which is not possible in practice.
According to Tuoi Tre - H
