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12. Maternal mortality
Author(s) -
ROSSITER C. E.
Publication year - 1985
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1985.tb15876.x
Subject(s) - medicine , obstructed labour , eclampsia , obstetrics , caesarean section , pregnancy , mortality rate , maternal mortality rate , perinatal mortality , pediatrics , population , fetus , health services , surgery , environmental health , genetics , biology
Summary. There were 238 maternal deaths. Five deaths occurred after delivery among booked women who had no antenatal complications (0.4 deaths per 1000 deliveries); 14 deaths were among booked women who developed complications during pregnancy (3.7 per 1000); and 219 deaths were in the emergency admissions (28.6 per 1000). Bacterial infections, eclampsia, anaemia, haemorrhage and disproportion together with its consequences, were the leading causes. The principal high‐risk factors were lack of antenatal care, early teenage pregnancy, high parity and high child mortality rate from previous births. In the emergency admissions the operative delivery rate was 25% in the women who survived and 49% in those who died. In severe eclampsia and in neglected obstructed labour, a high haematocrit (≥0.45) and, to a lesser extent, a low haematocrit (≥0.14) were of ominous significance, mortality rate being 25–60% in such cases compared with <10% in most other obstetric complications. Measures to reduce maternal mortality should aim to lower the proportion of high‐risk women (40% at present) and also make it possible for operative deliveries, especially caesarean section, to be performed as soon as the need arises.