10 women died due to excessive bleeding during child birth

TOKYO - Ten out of the 16 women who died due to excessive bleeding while giving birth last year might have been saved if blood transfusions or other treatment had been properly administered, according to a study panel of the Health, Labor and Welfare Ministry.

The panel determined the 10 women were treated too late because doctors failed to notice internal bleeding or necessary blood products were not on hand.

In cooperation with the Japan Association of Obstetricians and Gynecologists, the panel collected medical records and other data from about 15,000 obstetricians and gynecologists nationwide. It analyzed the causes of deaths and whether treatment had been appropriate.

The 16 women were residents of Tokyo, Hyogo, Saitama and six other prefectures, and ranged in age from 26 to 42. They suffered blood loss of 1.4 liters to 17 liters.

Seventeen liters is much more than the average woman's body would contain, but such blood loss is possible in tandem with transfusions.

The panel judged it was highly likely 10 of the women could have been saved.

A 39-year-old woman who gave birth at a large women's hospital that handles thousands of deliveries a year began bleeding due to a rupture in her uterus.

Her blood pressure fell abnormally low and emergency blood infusions were started an hour later. However, the hospital did not have enough blood products, leading doctors to insert too much gauze into her uterus in an attempt to stop the bleeding.

One member of the panel said, "Preparations for blood transfusions were insufficient." Another member said, "The gauze may have exacerbated the wound."

In all 10 cases, it took at least an hour from the emergence of abnormalities to the start of blood transfusions. The panel determined the doctors failed to notice signs of hemorrhagic shock or properly prepare for blood transfusions.

Excessive bleeding is responsible for the largest percentage of deaths among pregnant women. In Japan, the probability of excessive bleeding is one in 300 deliveries.

The panel believes many clinics do not stock blood transfusion products, which expire. Clinics handle about half the 1 million deliveries that take place annually.

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