KARACHI, July 3: The absence of treatment and inaccessibility of local women to expensive diagnostic facilities is feared to have fast turned Hepatitis E into the major factors contributory to maternal deaths in the city.
Gynaecologists and obstetricians discussing the issue of maternal mortality and available intervention at an ongoing workshop at the PMA House on Wednesday observed that Hepatitis E was fast emerging as a significant risk factor for local mothers.
They regretted that since a vast majority of the local government-owned maternity units were devoid of the facility, delay in diagnosis exposed women to serious risks, including mortality.
Moreover, since the diagnostic facility itself was quite expensive, coming to Rs5,000 for a single test, not affordable for most local families, would-be mothers were in no position to seek timely intervention.
Dr Nighat Shah of the Murshid Hospital on the basis of her experience at the hospital said at least four maternal deaths reported during one year were due to Hepatitis E. These women were neither booked nor among those visiting for regular checkups.
Hepatitis E, a water-borne infection, plays havoc with pregnant women as they, undergoing metabolic changes and weak immunity, are often in little position to resist the severity of the virus. Hepatitis E induced mortality is registered to increase by 20 per cent among pregnant women.
On the occasion, Dr Shabeen Naz Masood, in charge of the Sobhraj Maternity Hospital, in her presentation cited “Central Obesity” as a grave risk for “Diabetes” among both pregnant and non-pregnant women.
Citing gestational diabetes a growing problem among local expecting mothers, she warned that those having experienced miscarriages, still births or might had delivered babies, weighing above three pounds, or have first-degree family history, were more vulnerable to the ailment.
Referring to 5,550 patients registered at the Sobhraj Hospital during June 2001 to June 2002, she said 22 per cent were found to be diabetic. A considerably alarming situation was the fact that 50 per cent of these diabetic patients had booked themselves late, in third trimester, while many of them also failed to visit the hospital regularly.
“Had these mothers got themselves booked early and thus be screened in time, there practically would not have been any fetal loss,” Dr Masood said mentioning that ten of these diabetic mothers lost their babies.
She said that though ideally all expecting women must be screened, however owing to the cost and logistic barriers, it would be appropriate that those at high risk be necessarily screened and provided with proper intervention.
Dr Masood also stressed that each hospital must have a screening protocol mentioning that WHO subscribed protocol meant for developing countries was being applied at Sobhraj for the past seven years.
She also stressed that excessive eating, excessive urination and excessive weight had to be contained among pregnant women ultimately reducing the loss of new born as well as preventing mother from associated complications as blood pressure and genital as well as urinary-tract infections.
Dr Shireen Bhutta on the occasion discussed Audit-Analysis of Work for Better Patient Care and also for the sake of ongoing education of doctors. According to her, regular and proper audit on part of head of department might considerably reduce the existent rate of maternal as well as infant mortality rate in the country.
Dr Samina Hamid of Hamdard Hospital enumerated infections, poor socio-economic conditions and repeated pregnancies as major cause for pre-term labour.
Dr Shaheen Zafar of the Liaquat National Hospital discussed the issue of hypertension among expecting mothers.
All speakers were unanimous that health care providers, particularly gynaecologists and obstetricians, needed to adopt a sympathetic attitude towards women approaching hospitals and health care outlets against all odds.—APP