Sikkim Launches High-Level Inquiry Into Maternal and Neonatal Deaths at STNM Hospital

GANGTOK – The Sikkim Health and Family Welfare Department has launched a formal investigation following the tragic deaths of a pregnant woman and her unborn twins at the state’s premier medical facility. On May 8, 2026, government officials convened a five-member inquiry committee to probe the circumstances surrounding the passing of Sweta Karki and her infants at the Sir Thutob Namgyal Memorial (STNM) Hospital in Sochakgang.

The probe comes in the wake of serious allegations of medical negligence leveled by the family, sparking a national conversation regarding maternal safety protocols in high-risk pregnancies within the Himalayan region.

The Incident: A Timeline of Tragedy

Sweta Karki, a resident of the Gyalshing district, was admitted to STNM Hospital—a tertiary care center—expecting twins. According to hospital records and family statements, the unborn twins died on May 6, 2026, while Karki was still under the facility’s care.

Following the loss of her children, Karki’s condition reportedly deteriorated, leading to a referral for advanced care at an undisclosed secondary location. She passed away shortly after the transfer. Her husband, Swarup Chettri, has publicly alleged that delays in treatment and breaches in standard obstetric protocols contributed to the triple tragedy.

The official government order, issued from the Tashiling Secretariat, mandates a comprehensive review of the clinical management provided to Karki from the moment of admission to her final referral.

Understanding the Risks: The Complexity of Twin Pregnancies

While the investigation is ongoing, medical experts note that multifetal pregnancies are inherently high-risk. According to clinical guidelines from Médecins Sans Frontières (MSF), complications such as preterm labor, fetal distress, and maternal hemorrhage are up to four times more likely in twin pregnancies than in singleton births.

Standard obstetric protocols for twins require:

• Continuous Fetal Monitoring: Tracking the heart rates of both infants simultaneously.

• Interval Management: A mandatory 15-to-30-minute rest period after the delivery of the first twin to assess the position of the second.

• Controlled Intervention: Delaying the administration of oxytocin until both infants are delivered to prevent uterine atony (failure of the uterus to contract), which can lead to fatal bleeding.

“Inquiry committees like this are vital for transparency,” says Dr. Sandhya Kamath, an obstetrician-gynecologist at AIIMS New Delhi, who is not involved in the case. “In twin deliveries, protocols demand vigilant management. Statistically, 80% of twin losses are tied to prematurity or malpresentation—factors that can often be managed with skilled, real-time monitoring and timely surgical intervention.”

The Inquiry Mandate

The five-member panel is composed of senior medical and administrative officials, including Pema Seden Lepcha, Suresh Madan Rasaily, Anup Pradhan, Pooja Lohar, and Pratiksha Sharma. The team draws expertise from the Health Department, STNM Hospital, and the Central Referral Hospital in Tadong.

The committee’s objectives include:

1. Verifying adherence to established obstetric protocols.

2. Assessing the timeliness of emergency interventions (e.g., Cesarean sections).

3. Identifying systemic lapses in the referral chain.

4. Submitting a final accountability report by May 15, 2026.

Maternal Health in the Himalayan Context

Sikkim’s Maternal Mortality Ratio (MMR) currently fluctuates between 70 and 90 per 100,000 live births. While this outperforms India’s national average, it remains above the United Nations Sustainable Development Goal (SDG) target of fewer than 70 deaths by 2030.

The state face unique geographic challenges. Referrals from rural districts like Gyalshing to the capital, Gangtok, often involve treacherous terrain and significant travel time. Public health experts suggest that these “geographic barriers” can turn manageable complications into life-threatening emergencies.

Dr. Rajib Das, a public health specialist with the Indian Council of Medical Research (ICMR), notes that the investigation must look beyond individual errors. “Sikkim’s terrain demands robust referral systems. Lapses here could signal training gaps under the National Health Mission (NHM). Maternal death audits are essential not just for accountability, but for driving the systemic fixes required by WHO guidelines.”

Balanced Perspectives and Potential Limitations

While the urgency of the probe responds to the family’s grief and public outcry, health advocates caution against premature conclusions. Twin pregnancies carry significant inherent biological risks that can result in poor outcomes despite the best medical care.

Furthermore, STNM Hospital serves as the primary hub for the entire state, often facing patient overloads that can strain resources. Past inquiries at the facility have led to staff suspensions, demonstrating a precedent for accountability, but critics argue that a one-week timeline may be too short for a truly exhaustive clinical audit.

What This Means for Patients

For expectant mothers, particularly those with multifetal pregnancies, this case underscores the importance of:

• Early Detection: Seeking early and regular ultrasounds to confirm fetal positioning.

• High-Level Care: Choosing facilities equipped with Neonatal Intensive Care Units (NICU) and 24/7 surgical capabilities.

• Community Resources: Utilizing ASHA workers and government programs like Janani Suraksha Yojana (JSY) for subsidized transport and institutional delivery.

The findings of this inquiry, expected later this month, will likely serve as a pivotal moment for Sikkim’s healthcare infrastructure, potentially leading to stricter enforcement of the “Dakshata” training for intrapartum care across the state.

Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.

References

• Voice of Sikkim. (2026, May 8). Sikkim Govt Orders Probe Into Death Of Mother and Unborn Twins at STNM Hospital