Citation

Bødker B, Hvidman L, Weber T, Møller M, Sørensen JL. Dan. Med. J. 2021; 68(9).

Copyright

(Copyright © 2021, Danish Medical Association)

DOI

unavailable

PMID

unavailable

Abstract

INTRODUCTION. Although women rarely die during pregnancy and childbirth in Denmark, keeping track of the maternal mortality rate and causes of death is vital in identifying learning points for future management of critical illness among obstetric patients and in pinpointing risk factors.

METHODS. We identified maternal deaths between 2002 and 2017 by linking four Danish national health registers, using death certificates and reports from hospitals. An audit group then categorised each case by cause of death before identifying any suboptimal care and learning points, which may serve as a foundation for national guidelines and educational strategies.

RESULTS. Seventy women died during pregnancy or within six weeks of a pregnancy in the study period. The most frequent causes of death were cardiovascular disease (n = 14), hypertensive disorder (n = 10), suicide (n = 10) and thromboembolism (n = 7). Suboptimal care was identified in 30 of the 70 cases.

CONCLUSIONS. Mortality from some of the most important causes of death decreased during the study period. No deaths from preeclampsia or thrombosis, two of the leading causes of death, were identified after 2011. In 2015-2017, suicide was the main cause of maternal death, which indicates that a stronger focus on vulnerability in pregnancy and childbirth is essential. Among the 70 deaths, 34% were potentially avoidable, indicating that it is essential continuously to focus on how to reduce severe maternal morbidity and mortality. © 2021, Almindelige Danske Laegeforening. All rights reserved.

Language: en

Keywords

adult; human; learning; homicide; suicide; female; multiple organ failure; autopsy; abdominal pain; traffic accident; heart failure; maternal death; maternal mortality; pregnancy; epilepsy; major clinical study; clinical practice; health care quality; blood sampling; breast cancer; lung embolism; sepsis; seizure; heart arrest; asthma; cardiovascular disease; lung edema; neurologic disease; diabetes mellitus; alanine aminotransferase; antibiotic agent; hypoglycemia; death certificate; cesarean section; ectopic pregnancy; first trimester pregnancy; thromboembolism; dyspnea; nausea and vomiting; blood clotting disorder; blood pressure; body mass; thrombosis; preeclampsia; hemolysis; Article; puerperium; labor; amnion fluid embolism; maternal hypertension; puerperal infection; chorionic gonadotropin; toxic shock syndrome; Escherichia coli; maternal morbidity; pulmonary hypertension; heart ejection fraction; pregnancy diabetes mellitus; epidermolysis; necrotizing fasciitis; ultrasound; hypertransaminasemia; obstetric hemorrhage; brain hernia; clinical audit; malignant neoplasm; gastric bypass surgery; academic underachievement; heart tissue; cause of death registry; fibroma; group A streptococcal infection; HELLP syndrome; peripartum cardiomyopathy; placenta accreta; thrombosis prevention