Open AccessMaternal deaths in the Nordic countries
Author(s) -
Vangen Siri,
Bødker Birgit,
Ellingsen Liv,
Saltvedt Sissel,
Gissler Mika,
Geirsson Reynir T.,
Nyfløt Lill T.
Publication year - 2017
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13172
Subject(s) - medicine , seriousness , maternal death , cause of death , audit , standardized mortality ratio , disease , pregnancy , eclampsia , preeclampsia , pediatrics , medical emergency , emergency medicine , demography , environmental health , population , pathology , management , biology , political science , law , economics , genetics , sociology
Despite the seriousness of the event, maternal deaths are substantially underreported. There is often a missed opportunity to learn from such tragedies. The aim of the study was to identify maternal deaths in the five Nordic countries, to classify causes of death based on internationally acknowledged criteria, and to identify areas that would benefit from further teaching, training or research to possibly reduce the number of maternal deaths. Material and methods We present data for the years 2005–2013. National audit groups collected data by linkage of registers and direct reporting from hospitals. Each case was then assessed to determine the cause of death, and level of care provided. Potential improvements to care were evaluated. Results We registered 168 maternal deaths, 90 direct and 78 indirect cases. The maternal mortality ratio was 7.2/100 000 live births ranging from 6.8 to 8.1 between the countries. Cardiac disease ( n = 29) was the most frequent cause of death, followed by preeclampsia ( n = 24), thromboembolism ( n = 20) and suicide ( n = 20). Improvements to care which could potentially have made a difference to the outcome were identified in one‐third of the deaths, i.e. in as many as 60% of preeclamptic, 45% of thromboembolic, and 32% of the deaths from cardiac disease. Conclusion Direct deaths exceeded indirect maternal deaths in the Nordic countries. To reduce maternal deaths, increased efforts to better implement existing clinical guidelines seem warranted, particularly for preeclampsia, thromboembolism and cardiac disease. More knowledge is also needed about what contributes to suicidal maternal deaths.