Over the past recent two weeks, the country has seen six expectant mothers die during labour. The situation has raised public concerns over the high levels of fatalities.
High rate of fatality
Dr. Tran Ngoc Hai, from the HCM City-based Tu Du Obstetrics Hospital, said obstetric ward recorded the highest fatality rates in the country’s health sector.
“In the 1980s, 250 of every 100,000 expectant mothers died during labour in Vietnam. Despite the rate decreasing to 75 per 100,000 births, it is still five times higher than developed countries,” he noted.
He added that there could be difficulties with births whether naturally induced or assisted by surgery.
On May 9, HCM City Department of Health’s Science Council provided the results of a case where a 30 year-old expectant mother Ngo Thi Thu Hong, from Hoc Mon District, died during a caesarean birth. They said that the situation happened as a result of an amniotic fluid embolism.
Associate Prof. cum Dr. Vu Thi Nhung, Chairwoman of the HCM City Obstetrics Association said the rate of amniotic fluid embolism was estimated at from 1/8,000-1/30,000 pregnant women and the situation could not be prevented as it often happened unexpectedly, often proving beyond the capabilities of less experienced medical staff at local levels.
Nhung shared that amniotic fluid embolisms often posed a 90% risk of mortality despite its very low frequency. The incident often strikes expectant mothers at the end of her labour, when amniotic fluid to flow into the patient’s veins, heart, lung and then brain and causing respiratory distress.
Caesarean sections not any safer
Doctor Vu Thi Nhung added that while amniotic fluid embolisms happened were something that couldn’t be avoided, other causes of maternal mortality could be prevented.
“Many pregnant women do not take regular prenatal check-ups in order to detect possible health problems early enough. Some have experienced abnormal signs but are unaware of the possible dangers. They just go to see doctors when things are too late. In other cases, mothers suffering from a fever after labour think it’s a symptom of flu. However, the real cause is postnatal infections, which may pose a threat to the mother’s life if they receive medical attention too late.”
After several expectant mothers died during natural labour, many have opted for surgery believing it may be safer. However, Nhung said, there was no evidence to prove this.
“Actually maternal and infant child mortality rates during caesarean sections are much higher than natural labour. Maternal mortality rates during a caesarean are four times higher than through natural labour. Children born through caesarean face a risk of respiratory distress from 1.9-2.6 times higher than those born by natural labour,” she emphasised.
Children who are born by caesarean often have worse immune systems than those who born naturally, she added.
In Vietnam, haemorrhaging is the major cause of maternal mortality, accounting for 41% of all cases, followed by pre-eclampsia with 21.3%, postnatal infections with 16.6% and unsafe abortion at 11.5%.