ROME • Italian health authorities have ordered investigations after five women died in childbirth in seven days, shocking a nation with one of the lowest maternal mortality rates in the world.
The deaths occurred across the country between Dec 25 and 31.
While all appear to have explicable causes, their concentration over the holiday period has raised questions over whether hospital staffing may have been a factor and also over whether older mothers-to-be are being sufficiently monitored for warning signs of potentially fatal conditions.
In the latest case, Ms Giovanna Lazzari, 29, a mother of two who was eight months pregnant, died on New Year's Eve in Brescia, northern Italy, a day after going to an emergency unit with a high fever and symptoms of gastroenteritis, according to her partner Roberto Coppini.
As her condition deteriorated, doctors attempted an emergency caesarean operation but were unable to save either the mother or the foetus. "In a few hours, I lost a baby and a unique mamma. Someone has to tell me what happened," Mr Coppini told reporters.
With preventative checks, we could save so many women in the delivery room. But the Health Ministry does not say they are required, in reality because they cost too much.
PROF ROSALBA PAESANO, of Rome's La Sapienza university, on the need to screen for the risk of heart problems
"Giovanna sent me a text message during the night in which she told me she had very strong pains but that the doctors were not paying any attention to her.
"She would have been 30 on Jan 1. She was young and healthy."
Mr Ezio Belleri, the hospital's director-general, said an initial review of Ms Lazzari's treatment had not found any indication of errors. The cause of death had been septic shock brought on by haemorrhaging that was likely the result of an unpredictably rapid spread of a very strong bacterial infection.
Health Minister Beatrice Lorenzin has dispatched experts to establish what happened in Brescia and three of the other four fatal cases. "We have to understand if the recommended procedures were followed or if there were organisational deficiencies," Ms Lorenzin said on Sunday.
In two of the other cases, both of which resulted in still births, the mothers, aged 35 and 39, suffered cardiac arrest during labour.
The other fatality was Dr Anna Massignan, a 34-year-old doctor who died after an emergency caesarean operation eight months into her pregnancy, reportedly following a fall at home. Her son was delivered alive but died later.
A leading gynaecologist said some of the victims may have paid the price of inadequate screening for the risk of thrombosis or heart problems emerging during the later stages of pregnancy.
"With preventative checks, we could save so many women in the delivery room," said Professor Rosalba Paesano of Rome's La Sapienza university. "But the Health Ministry does not say they are required, in reality because they cost too much. The procedures we have in place are obsolete," Prof Paesano told La Repubblica.
Consumer group Codacons said it would be filing requests for prosecutors to look into whether regional authorities and the Health Ministry had been negligent in their instructions to hospitals regarding screening measures and preventative treatment.
Medical director Antonio Starita at Rome's San Camillo Hospital told La Stampa that blocks on new hires in parts of the health system could be creating staff shortages, particularly among midwives assigned to home visits who could pick up early warning signs of problems in a pregnancy.
According to World Bank figures, Italy has had an average of four maternal deaths in pregnancy per 100,000 live births since 2004, one of the 10 lowest mortality rates in the world.