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

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17 Issues for General Practitioners
Box 17.2
Key signs and symptoms of possible serious illness in pregnant women or recently delivered mothers.
The following signs should alert all health professionals including midwives, GPs, junior doctors and
obstetric and other consultants that serious illness is a possibility:
• A heart rate greater than 100bpm,
• A systolic blood pressure of 160 mm/Hg or above or lower than 90 mm/Hg, and /or a diastolic
blood pressure of 90 mm/Hg, or more.
• A temperature greater than 38 degrees Centigrade and/or
• A respiratory rate more than 21 breaths per minute. The respiratory rate is often overlooked but
rates over 30 per minute are indicative of a serious problem.
Recognising “red fl ags” when pregnant women need emergency hospital admission
This section highlights the key clinical issues that have emerged in reviewing many of the maternal deaths
discussed in this Report where there was scope for improvement in GP management, due to of a lack of
either knowledge or skills. Further and fuller details are contained within the individual chapters relating
specifi cally to each cause of death and these are can also be readily downloaded from www.cemach.org.uk.
Breathlessness may be due to pulmonary embolus (PE)
The number of women who died from thromboembolism, particularly in early pregnancy, has increased in
this triennium despite the continuing decline in those following caesarean section which have continued to
fall as thromboprophylaxis becomes routine. Most of the women who died of pulmonary embolus (PE) had
the well-known risk factors for PE, especially obesity, and could have been identifi ed as being at higher risk
in pregnancy. The risk factors are given in Box 17.3.