Saving Mothers' Lives: - Public Health Agency for Northern Ireland

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11 Cancer and other tumours
Table 11.1
Numbers of deaths which were assessed by malignancy and type of maternal death; United Kingdom 2003-05.
Malignancy Direct Indirect Coincidental Late
Direct
Late
Indirect
Late
Coincidental
Choriocarcinoma 1 0 0 3 0 0 4
Breast 0 1 1* 0 7 0 9
Brain 0 2 2* 0 3 2 9
Blood 0 2 0 0 5 1 8
Melanoma 0 1 0 0 7 0 8
Ovary 0 0 0 0 2 0 2
Vulva or Uterus 0 0 0 0 3 0 3
Lung 0 2 2 0 0 7 11
GI Tract 0 1 6 0 0 6 13
Renal 0 0 0 0 0 3 3
Skeletal 0 0 1 0 0 2 3
Other 0 0 1 0 0 3 4
Unknown primary 0 0 3 0 0 2 5
Total 1 9 16 3 27 26 82
* Although these tumours may be aggravated by pregnancy, in these cases the assessors considered the deaths to be unrelated
to pregnancy.
Overall the more intensive assessment of Late Coincidental cases carried out this triennium has shown
that there are very few additional lessons to be drawn from most of these deaths, and such detailed
assessments will not be routinely undertaken in future Reports.
In many cases, a high, sometimes outstanding level of care was given to the woman and her family once
the diagnosis had been made. In a signifi cant number of cases however, as has been discussed in many
previous Reports, the opportunity to make the diagnosis earlier was missed despite overt symptomatology.
Whilst this may not have affected the eventual outcome, earlier diagnosis would have enabled the woman
to be made as comfortable as possible for the last months of her life as well as enabling earlier access to
further medical care and the support services she and her family required.
The women who died
The ages of the women ranged between 17 and 46 years, with the median age being 31 years. About half
who died were primiparous, but several were mothers with a signifi cant number of children; a small number
had more than ten previous live births.
Six women were immigrants or refugees/asylum seekers who had recently arrived in the UK. A further two
appeared to have arrived late in their antenatal period seeking care for their pregnancy and/or their cancer.
Six of these eight women spoke no English. One did not reveal her advanced breast cancer to her midwife
at booking and had midwifery-led care until she revealed her history some months later, when terminally
ill. The youngest of the refugees, a single, isolated teenager who had also recently arrived in the UK, was
one of the four African women in this Report who was reported to be pregnant as the result of rape by
soldiers in a war-torn country. It is likely that the stigma of rape delayed her seeking care until just before
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