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Intracranial haemorrhage as a cause of maternal mortality during 1991–1992 in Japan: a report of the Confidential Inquiry into Maternal Deaths Research Group in Japan
Author(s) -
Sameshima Hiroshi,
Nagaya Ken
Publication year - 1999
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.1471-0528.1999.tb08143.x
Subject(s) - medicine , intracranial haemorrhage , pregnancy , maternal death , medical record , maternal morbidity , retrospective cohort study , pediatrics , obstetrics , cause of death , surgery , complication , population , genetics , environmental health , disease , pathology , biology
Objective To determine the causes of maternal deaths by intracranial haemorrhage in Japan. Design Retrospective analysis of records relating to maternal deaths in 1991 and 1992. Samples Two hundred and thirty maternal deaths, including 25 cases of primary intracranial haemorrhage and two cases with secondary bleeding. Methods Attending doctors were interviewed and completed a 600‐item data collection instrument for each maternal death. An expert committee reviewed the data for each death to determine whether the maternal deaths could have been prevented. Main outcome measures Preventability of maternal death from intracranial haemorrhage treated in obstetric and emergency services in Japan. Results Half of the primary intracranial haemorrhages occurred during pregnancy, 20% during labour, and 30% in the postnatal period. Neurosurgeons considered that there were only three women in whom surgical drainage was indicated. The committee determined that there was only one maternal death which had a 2 70% of being prevented. After detailed discussion of each case, 60% of the women (15/25) may have been saved by earlier and more intensive medical intervention. Conclusions These findings suggest that detailed history taking and early diagnosis of intracranial haemorrhage would be helpful. Regionalisation of obstetric emergency systems are necessary to reduce maternal deaths in Japan due to intracranial haemorrhage.