UK maternal death rate is falling

UK maternal death rate is falling

The report published today says that maternal deaths in the UK have dropped from 11 per 100,000 women giving birth in 2006–08 to 10 per 100,000 women giving birth in 2010–12. Saving Lives, Improving Mothers’ Care: Lessons learned to inform future maternity care from the 2009–2012 UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity, is being published at a meeting at the Royal College of Obstetricians and Gynaecologists being held today in London.

The report, led by the National Perinatal Epidemiology Unit, University of Oxford, specifically by a team of academics, clinicians and charity representatives called MBRRACE-UK, included all 357 cases of women in Britain who died during or within six weeks of the end of their pregnancy in those four years.

The researchers found the fall in maternal deaths was due to a reduction in deaths due to pregnancy complications such as eclampsia, blood loss or blood clots. However, the majority of women who died during or within 6 weeks of the end of their pregnancy died from other medical conditions, such as heart disease, neurological conditions or mental health problems.

Two-thirds of mothers died from these indirect causes rather than pregnancy complications, and the rate of indirect deaths has not fallen in the past 10 years. Furthermore, three-quarters of women who died had pre-existing medical and mental health problems before they became pregnant. The Oxford University researchers, therefore, said women with pre-existing conditions needed better pre-pregnancy advice as well as joint specialist and maternity care through pregnancy and birth.

Action could also be taken be dealing better with sepsis and flu vaccination, said the authors who reviewed the care of women who died from sepsis and also women who survived an episode of septic shock. In the report, they emphasise the need for healthcare staff to “think Sepsis” at an early stage when seeing an unwell pregnant or recently pregnant woman and to ensure that these women got an early diagnosis, were put on antibiotics rapidly and that senior doctors and midwives were consulted quickly.

If clinicians managed to increase flu vaccination rates among pregnant women, that could also help to save lives. One in 11 of the women who died had flu and more than half of these deaths occurred after a flu vaccine was made available to pregnant women.

Professor Marian Knight of the National Perinatal Epidemiology Unit, who led the enquiry, said: “There is a need, above all, for coordinated and concerted action at all levels to improve the care of women with medical complications before, during and after pregnancy.

“The fact that the maternal mortality rate continues to come down at a time when we are seeing greater numbers of births in the UK and more complex pregnancies shows the dedication of so many doctors, nurses, midwives and other health professionals to improving maternity care.”

Professor Alan Cameron, vice president of clinical quality for the Royal College of Obstetricians and Gynaecologists, said: “More needs to be done to address maternal deaths from indirect causes, both from medical and mental health conditions, as deaths from these causes have not decreased over the last 10 years.”

By Adrian O'Dowd,

OnMedica, Tuesday 09 December 2014

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