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At least 19 recordsLinked to original sources
PubMedDate not supplied

When is a maternal death a maternal death? A review of maternal deaths at the Mercy Maternity Hospital, Melbourne.

The limiting of the reporting of maternal deaths to those that are included in the criteria of the World Health Organization excludes deaths which yield useful information for further improvements in clinical performance. In this series of 22 maternal deaths, six deaths would have been excluded from reporting: one "direct" obstetric death of pre-eclampsia; one "indirect" death as a result of renal and cardiac failure; two deaths as a result of postnatal depression which led to suicide three and four months postpartum, respectively; and two deaths of cancers, where diagnostic delay may have been a result of the coexistent pregnancy. The importance of primary pulmonary hypertension, cardiomyopathy and psychiatric illness is emphasized. We endorse the recent recommendation of the International Federation of Gynaecology and Obstetrics (FIGO) that all maternal deaths that occur more than 42 days after the end of a pregnancy should be assessed for possible relationships with childbirth, and suggest that a time limit of one year would include all deaths that are worthy of scrutiny.

Adult↗
PubMed1980

Maternal death. A review of maternal deaths at one hospital from 1958 to 1978.

A retrospective examination of all maternal deaths at Queen Charlotte's Hospital in the last 20 years shows that general anaesthesia is the greatest single cause of maternal death. This highlights the need for considerable reduction in the inherently dangerous technique of general anaesthesia to patients in labour and, where possible, its replacement by extradural and spinal blocks.

Adult↗
PubMed2004

Pregnancy-related maternal deaths.

Pregnancy is a normal biologic process, but because of a variety of physiologic factors, it increases a woman's risk for death. Maternal deaths in pregnancy may be due to conditions unique to pregnancy, conditions associated with pregnancy, or conditions unrelated to but exacerbated by pregnancy. Death may occur during any trimester, during labor/birth, or postpartum. In this report, we present 45 cases of pregnancy-related maternal deaths that were investigated and autopsied at the Dallas County Medical Examiners office between 1977 and 1999, and we review the topic of pregnancy-related maternal death.

Adolescent↗
PubMed1995

A comparison of sisterhood information on causes of maternal death with the registration causes of maternal death in Matlab, Bangladesh.

BACKGROUND: To explore whether causes of maternal death can be investigated using the sisterhood method, an indirect method for providing a community-based estimate of the level of maternal mortality, this study compares the sisterhood causes of maternal death with the Matlab Demographic Surveillance System's (DSS) causes of maternal death. METHODS: Data for this study came from the Matlab DSS, which has been in operation since 1966 as a field site of the International Centre for Diarrhoeal Disease Research, Bangladesh. The maternal deaths that occurred during the 15-year period from 1976 to 1990 in the Matlab DSS area are the basis of this study. A sisterhood survey was conducted in Matlab in November and December 1991 to collect information on conditions, events and symptoms that preceded death. The collected information was evaluated to assign a most likely cause of maternal death. The sisterhood survey cause of maternal death was then compared with the DSS cause of maternal death. RESULTS: Cause of death could not be assigned with reasonable confidence for 34 (11%) of the 305 maternal deaths for which information was collected. For the remaining deaths, the agreement between the two classification systems was generally high for most cause-of-death categories considered. CONCLUSIONS: Though cause-of-death information obtained by the sisterhood method will always be subject to some error, it can provide an indication of an overall distribution of causes of maternal deaths. This data can be used for the planning of programmes aimed at reducing maternal mortality and for the evaluation of such programmes over time.

Abortion, Induced↗
PubMed1986

Maternal deaths at Harare Maternity Hospital during 1983.

There were 51 maternal deaths at Harare Maternity Hospital, Zimbabwe, during 1983, 25 among patients from the greater Harare area and 26 among patients referred from peripheral hospitals or clinics. The overall maternal mortality rate among patients within the greater Harare area was 56/100 000 (including deaths related to abortion). Among 'booked' patients the maternal mortality rate was 29/100 000. Puerperal sepsis, haemorrhage, post-abortal sepsis and hypertensive disease accounted for 78.4% of the deaths. Avoidable factors, considered to be present in 34 cases (66.7%), are discussed.

Adolescent↗
PubMed2000

A review of maternal deaths in South Africa during 1998. National Committee on Confidential Enquiries into Maternal Deaths.

OBJECTIVE: To document the prevalence and causes of maternal mortality and to identify avoidable factors, missed opportunities and substandard care related to these deaths. METHOD: Maternal deaths are notifiable; when a maternal death occurs a maternal death notification form is filled in and sent to the provincial Maternal, Child and Women's Health (MCWH) units. Provincial assessors assess the death and submit a report. This report is forwarded to the National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD), where the data are collated and the prevalence, pattern of disease, avoidable factors, missed opportunities and substandard care pertaining to maternal deaths are described. RESULTS: Data were collected on the maternal deaths occurring during 1998 in South Africa. Collection of data on maternal deaths was incomplete and a maternal mortality ratio could not be calculated. However, a clear pattern of disease and problems in patient care emerged. The 'big five' causes of death were complications of hypertensive conditions in pregnancy, AIDS, obstetric haemorrhage, pregnancy-related sepsis and pre-existing medical conditions. Women aged 30 years and older were at greater risk of dying than younger women. Women in their first pregnancy or who had had 5 or more pregnancies were also at greater risk. Obstetric haemorrhage was the most common cause of death at level 1 hospitals, AIDS at level 2 hospitals and hypertensive diseases at level 3 hospitals. The vast majority of anaesthetic-related deaths occurred at level 1 hospitals. Non-attendance and delayed attendance at the health institutions were the most common patient-orientated problems. Poor transport facilities and lack of intensive care facilities were the major administrative problems. Problems in the care of women occurred in more than half the cases of maternal death, the majority at the primary level of care. Poor initial assessment and diagnosis of cases, especially at secondary level of care, failure to follow standard protocols at primary and secondary levels, and poor monitoring of patients at all levels of care were the common health worker-related problems. CONCLUSION: Ten key recommendations based on this information have been made by the NCCEMD; if implemented these will result in a reduction of maternal deaths.

Acquired Immunodeficiency Syndrome↗
PubMed1976

Maternal deaths in Texas, 1969 to 1973. A report of 501 consecutive maternal deaths from the Texas Medical Association's Committee on Maternal Health.

The Texas Medical Association's Committee on Maternal Health reports its experience with 501 consecutive maternal deaths. The committee structure and procedures are explained. Demographic and pathologic data are presented and discussed. The defects which allowed complications to proceed to death are analyzed and recommendations are made to reduce the number of these deaths.

Maternal Mortality↗
PubMed2003

[Death by AIDS or maternal death: classification of mortality as a social practice].

This paper analyzes the decision on whether to include deaths of HIV+ pregnant women in the classification of maternal mortality. The study focuses on deaths of childbearing-age women in S o Paulo in 1998, investigated by the State's Central Committee on Maternal Mortality (CCMM). Working from a social constructionist perspective, the research was based on documental analysis and interviews with the president of the CCMM and members of one regional committee. The analysis focused on the selection, investigation, and classification of maternal death, with special attention to the negotiation among various actors involved in the classificatory procedures. The data suggest that in the deaths of HIV+ women, other factors are present including the precedence of HIV status over maternal death and the moral and symbolic aspects of AIDS. The results suggest that improving data through a better understanding of decisions to include or exclude cases is only one side of the issue; it is also important to improve quality of care in pregnancy and childbirth in order to prevent maternal death.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Severe acute maternal morbidity and maternal death audit--a rapid diagnostic tool for evaluating maternal care.

OBJECTIVE: To analyse severe acute maternal morbidity (SAMM) and maternal mortality in the Pretoria region over a 2-year period (2000-2001). SETTING: Public hospitals in the Pretoria region, South Africa, serving a mainly indigent urban population. METHODS: A descriptive study was performed whereby women with SAMM and maternal deaths were identified at daily audit meetings and an audit form was completed for all cases fulfilling the definition of SAMM ('near miss') and for all maternal deaths. RESULTS: The number of maternal deaths declined slightly but not significantly from 18 deaths in 2000 to 16 in 2001. This represents a change in the maternal mortality ratio (MMR) from 130/100,000 live births in 2000 to a MMR of 100/100,000 live births in 2001. However, when data for women with SAMM and maternal deaths were combined, there was a significant increase in major maternal morbidity from 90 cases (SAMM and maternal death rate 649/100,000 live births) in 2000 to 142 cases (SAMM and maternal death rate 889/100,000 live births) in 2001 (p = 0.006). This increase was due to a significant increase in severe maternal morbidity related to abortions and obstetric haemorrhages. CONCLUSION: Analysis of maternal deaths only in the Pretoria region failed to identify abortions and haemorrhages as major maternal care problems. When data for women with SAMM were combined with data for maternal deaths, however, these problems were clearly identified, and remedial action could be taken. Including SAMM in maternal death audits increases the rapidity with which health system problems can be identified.

Abortion, Induced↗
PubMed1987

Maternal mortality in southern Africa, 1980-1982. Part II. Causes of maternal deaths.

Of 737 maternal deaths studied in southern Africa between January 1980 and December 1982, 660 were classified as direct obstetric deaths. Hypertensive disorders of pregnancy were the most frequent cause of death (30%). Obstetric haemorrhage and infection were associated with 20% and 19% of maternal deaths respectively. Advancing age and increased parity were strongly associated with death from obstetric haemorrhage.

Adolescent↗