No docs at PHC, allege kin, authorities blame poor health of woman CHENNAI: The head of a fetus got separated, leaving the rest of the body in the mother's womb, when a staff nurse and midwives at a primary health centre at Koovathur near Chennai attempted to facilitate a natural delivery. Doctors on Wednesday said the fetus had been dead in the womb for at least 48 hours and that the "accidental decapitation" could have happened because it was underweight, undernourished and macerated.The 26-year-old mother Bommi T was rushed to the government Chengalpattu Medical College Hospital with the rest of the fetus stuck inside her body. Doctors there removed the fetus.Earlier this year, the head of a fetus was stuck in a womb of a mother in Rajasthan . Me- dical literature shows similar cases in a London hospital, where an Indian doctor working for the NHS, was suspended for accidental decapitation. "The fetus was alive in both these cases when the women went into labour. But in Koovathur, the fetus was dead," said Dr Kumutha, national health mission consultant and neonatologist, who has been assigned to probe the case."The fetus did not have skin on some parts of the body. We don't yet know if there were any congenital or genetic disorders. Since the fetus was tiny, doctors managed to save the mother," Dr Kumutha said.The condition of mother, wife of a daily-wage labourer Thiyagarajan, is stable.Hospitaldean Dr Usha Sadasivam said, “The mother is very weak. She is anaemic and underweight. We are monitoring her closely.” Bommi’s relatives, meanwhile, protested outside the hospital and lodged a complaint with the Koovathur Police station alleging medical negligence.Her uncleDDhanushsaid nurses ignored her requests for pain relief and went ahead with a vaginal delivery. “There were no doctors at the PHC. They should have referred her to a bigger hospital,” he said.Bommi, who was in the 36th weekof pregnancy,had movedto her mother’s place in Koovathur from Tiruvallur on Monday. She came to the PHC at 6.30am with labour pain on Wednesday. She told the nurse that she had been experiencing “watery discharge”for nearly a day.“Her water broke and fluid had been draining for nearly a day. She was in active labour and tests showed absence of fetal heartbeat. There was no time. Nurses informed the family of her condition and rushed her to the labour ward because the fetus was already crowning,” said deputy director of health service Dr V K Palani.“Anydelaycouldhaveled to maternal death,” he said.The PHC, which has about five beds and a labour ward, had three staff nurses on duty at that time. Director of Public health Dr K Kolandaisamy said Bommi had told doctors that she conceived this baby two months after an abortion. “The gap between the pregnancies is too short. She gainedjust6kg during her pregnancy. The fetus weighed1.4kg againsttheexpected weight of at least 2.7kg. The umbilical cord was narrowedwith depleting nutrition supply. The placenta was less than half the required weight,” he said.The inquiry panel has suggested postmortem on the fetus. Meanwhile, based on the complaint of relatives, the Koovathur police registered a case of unnatural death. Police conducted inquiries with staff nurse Muthukumari. “She has told us that alldecisionsweretaken basedon instructionsfrom duty doctor Dr Arulmozhi. Bommi had to be shifted out of the PHC before the doctor could arrive. Investigations are on,” the police said.

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