Italy, which has one of the lowest maternal mortality rates in the world, suffered five deaths in seven days between December 25th and 31st.

That led some doctors to suggest staff shortages and cutbacks were endangering patients lives over the holiday period.

Leading gynaecologists suggested some of the patients might have been saved through better screening of older and overweight pregnant women at risk of thrombosis or heart problems.

Health Minister Beatrice Lorenzin ordered investigations into four of the five deaths, resulting in the preliminary report on Tuesday.

It said all appropriate procedures appeared to have been followed in the case of Angela Nesta, 39, who suffered a cardiac arrest leading to a still birth during her labour in a Turin clinic on December 29th.

In the other three cases, the report highlighted communication and organizational problems in the response to emergencies without suggesting that life-or-death mistakes had been made.

It talks of “some misalignment” in staff accounts of the treatment of 29-year-old Giovanna Lazzari, who died in a Brescia clinic on New Year's Eve, a day after arriving in its emergency unit eight months pregnant and showing symptoms of gastroenteritis.

In the case of Marta Lazzarin, who died in Bassano del Grappa in northeastern Italy on December 29th, the report said the hospital had not communicated clearly with her family about the level of risk she faced as a result of a bacterial infection.

It also allegedly failed to manage the patient's pain adequately.

But the report said antibiotics had been administered appropriately as soon as the possibility of a dangerous infection had been identified.

The report said the case of Anna Massignan, a 34-year-old doctor who died in a Verona hospital after an emergency caeseran on Christmas Day, raised several questions of an organizational and clinical nature.

The report suggests these may have impacted the speed with which a decision to order the surgery was made, but emphasised there was no preliminary indication a different outcome could have been achieved.

Doctors delivered Massignan's son alive but he died several hours later.

According to World Bank figures, Italy has had one of the ten lowest rates of maternal mortality for the last decade.