Rajawadi records three perinatal deaths in one day; BMC opens a probe

Three perinatal deaths were recorded in the maternity unit of Rajawadi Hospital in Ghatkopar on Wednesday, 26 August. The Brihanmumbai Municipal Corporation's health committee ordered an inquiry the next day. Chair Harish Bhandirge walked the ward on Thursday and took statements from superintendent Dr Chandrakant Pawar, senior medical officer Dr Bharti Rajulwala and the doctors on the three cases.

Hospital notes split the deaths. Two were intrauterine fetal deaths, confirmed before delivery. The third was a live birth after a caesarean at 40 weeks. That newborn developed bradycardia, was resuscitated, moved to the neonatal intensive care unit and died about two hours after birth. Civic officials told the Times of India there was no delay in treating the three women.

The three files

In the first case a woman at 37 weeks arrived with no fetal heartbeat. Scans confirmed the fetus had already died. In the second, a woman with diabetes and hypertension who had missed scheduled antenatal visits was found, on sonography, to have an intrauterine death. Those two files are still deaths in a municipal maternity ward. They are not the same clinical event as a collapse in the NICU.

The third case is the one that will draw the most scrutiny. Doctors detected meconium-stained liquor, took the woman to theatre and delivered by caesarean. The baby needed immediate resuscitation for a slow heart rate. Death followed inside two hours. The committee will want the cardiotocograph, the decision-to-incision interval, the NICU notes and the staffing roster for that shift.

Rajawadi is a busy peripheral hospital, not a tertiary maternity centre. High-risk women still arrive there because it is close and because referral to a larger unit can take time in city traffic. Missed antenatal visits, as in the second case, are a social fact as much as a hospital failure. A probe that only lists equipment will miss that. A probe that only lists the mother's record will miss a theatre or NICU lapse if one exists.

The wider Maharashtra context

Five days earlier, on 24 August, a fire in the NICU of the district women's hospital in Amravati killed three newborns. Staff evacuated 36 other infants. Six were moved to a super-speciality hospital. A ventilator is suspected as the ignition source. The state named a seven-member committee under health commissioner Sanjay Katkar and promised Rs 5 lakh to each family. That fire and the Rajawadi cluster are different mechanisms. They will be read together because both involve municipal or district maternity units in the same week.

Bhandirge's visit is the first official step in Mumbai. The committee can ask for independent case reviews. It can also close the file if the notes show unavoidable fetal death in the first two cases and a documented resuscitation in the third. Families have not yet been quoted in the main reports. The hospital has not released the names.

The useful number from Wednesday is three deaths in one maternity unit in 24 hours. The useful question for the inquiry is whether any of the three would have had a different outcome in a different building, with a different roster, or with antenatal care that the second woman did not attend.