Obstetrics, emergency depts must cooperate
Written by Writer on Friday, October 24th, 2008
Obstetrics, emergency depts must cooperate
Makiko Tatebayashi / Yomiuri Shimbun Staff Writer
In order to avoid a situation in which patients in need of emergency care are turned away by a succession of hospitals, improvements to the emergency treatment system must be made to ensure that key hospitals are able to accept patients around-the-clock.
Earlier this month, a pregnant woman suffered a brain hemorrhage and died after being refused by seven hospitals. Metropolitan Bokuto Hospital in Sumida Ward, Tokyo, initially refused a request to admit the woman, but later accepted her when it was contacted again, which prompts the question: Why did the hospital fail to swiftly admit the woman the first time?
Two years ago, a pregnant woman in Nara Prefecture died after being refused treatment from 19 hospitals. That woman also suffered a brain hemorrhage.
According to Tomoaki Ikeda, the director of the Department of Perinatology at the National Cardiovascular Center, women are susceptible to a brain hemorrhage during pregnancy and delivery, and it is the second leading cause of death for pregnant women.
General perinatal care centers, such as Metropolitan Bokuto Hospital, are designated as emergency care providers for mothers and newborns. As such, they are required to have obstetricians and pediatricians on staff.
However, as these centers do not expect to be called on to provide medical care for pregnant women suffering brain hemorrhages, not all are able provide emergency care for these patients.
Metropolitan Bokuto Hospital has an ER and an emergency care center that provide emergency care for seriously ill or injured patients, and has a good track record regarding the treatment of brain hemorrhage sufferers.
According to hospital sources, however, when the hospital’s general perinatal care center refused to accept the woman, it did not contact the ER, highlighting a lack of coordination between obstetricians and emergency doctors at the hospital.
“To save pregnant women’s lives, it’s necessary to establish a system that would allow for better communication between obstetrics departments and emergency care centers, as well as other sections,” Ikeda said.
ERs in Germany and some other European countries accept any patients regardless of the medical problem, including those normally seen by obstetrics departments.
In Japan, it also is necessary for ERs to be set up that are able to take in all patients and offer a wide range of medical care, including perinatal care. A move that would mean more obstetricians likely would be stationed at ERs.
In Miyazaki Prefecture, and other places, when a pregnant woman makes a request to be admitted to a clinic, the woman’s obstetrician goes to the hospital with her and works with doctors at the hospital.
If such a system were introduced nationwide, it would be necessary to establish a system that would promote improved interaction between private practitioners and hospital-based doctors.
(Oct. 24, 2008)
