“Saving Lives, Improving Mothers’ Care - Surveillance of maternal deaths in the UK 2012-14 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-14”
The third report of the Confidential Enquiry into Maternal Deaths issued by the MBRRACE-UK collaboration is published today.
Led by the MBRRACE-UK team at the National Perinatal Epidemiology Unit at the University of Oxford this report details the findings of maternal mortality surveillance 2012 to 2014 in the UK and the lessons learned from the confidential enquiries into maternal deaths from cardiovascular causes, blood pressure disorders of pregnancy, early pregnancy causes together with messages for critical care.
For women in the United Kingdom, giving birth remains safer than ever - less than 9 in every 100,000 women die in pregnancy and around childbirth. Overall the maternal mortality rate in the UK continues to fall although the reduction reported this year is smaller than previously. Deaths from ‘indirect’ causes remain the largest group of deaths; these are deaths from conditions not directly due to pregnancy but existing conditions which are exacerbated by pregnancy, for example, women with heart problems. Given the very gradual rate of decline and the complexity of medical conditions now experienced by women during pregnancy, achieving the Government’s ambition to reduce maternal deaths by 20% by 2020 and 50% by 2030 presents a major challenge for the health service which will require co-ordination of care across multiple specialities.
The care of more than 150 women who died from heart disease during pregnancy or in the year after giving birth between 2009 and 2014 was reviewed in detail. Heart disease is the leading cause of maternal death during or up to six weeks after the end of pregnancy. The enquiry found that in some cases diagnosis of heart disease in young women was overlooked and for others who knew they had heart disease, care was fragmented. Preventing women from dying from heart disease is essential to efforts to continue to reduce the number of women dying.
Despite blood pressure problems – pre-eclampsia and related complications - being very common in pregnancy, maternal deaths from these conditions are at their lowest rate ever. Now in the UK less than one woman in every million women dies from a blood pressure disorder of pregnancy. This is less than one woman every year compared with more than one woman every hour globally who dies from this condition. This is a great success of maternity care in the UK.
The report also contains messages for the future care of women with early pregnancy conditions including ectopic pregnancy and those women in pregnancy or soon after who require critical care.
Clear pointers for improving services and care by individual practitioners were identified and these are discussed in detail alongside the findings in the full report which can be download here.
Follow us on Twitter @mbrrace