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

Leading causes of maternal deaths: 2003-05
Direct deaths
The commonest cause of Direct maternal deaths was again thromboembolism. Although the rates appear to
have risen slightly, this is compatible with random variation. Similarly, although there appears to be a threefold
increase in the number of deaths due to Amniotic Fluid Embolism (AFE), these were largely concentrated
in the fi rst two years of the triennium and were largely unavoidable. The small variation in rates of deaths
from sepsis, pre-eclampsia/eclampsia, haemorrhage, anaesthesia and direct uterine trauma are no greater
than would be expected by chance. There was no under-reporting of any of these deaths.
Indirect deaths
Cardiac disease was the commonest cause of maternal death overall, and was more common than the
most frequent Direct cause of maternal death, thromboembolism. It also outnumbers deaths from suicide,
which was the leading overall cause of maternal death in the last Report.
The care the mothers received
Antenatal care
Table 1.4 shows the type of antenatal care provided for the mothers who died.
Table 1.4
Maternal deaths by type of antenatal care; United Kingdom: 2003-05.
Direct Indirect Direct and
Indirect
Type of Death
Coincidental Late
Direct
All
deaths
n n n (%) n n n (%)
Team-based or “shared” care 54 60 114 (39) 17 6 137 (33)
Consultant led unit only 15 39 54 (18) 9 1 64 (15)
Midwife only 11 16 27 (9) 8 0 35 (8)
Midwife and GP 5 4 9 (3) 6 3 18 (4)
Death before booking or after
miscarriages or TOP
22 9 31 (11) 5 0 36 (9)
Unaware of pregnancy 5 1 6 (2) 1 0 7 (2)
Suboptimal antenatal care:
Concealed pregnancy 3 2 5 (2) 0 0 5 (1)
No antenatal care 4 6 10 (3) 4 0 14 (3)
Late booker/poor attender 11 24 35 (12) 5 1 41 (10)
Not stated 2 2 4 (1) 55 0 59 (14)
All deaths 132 163 295 (100) 110 11 416 (100)**
* Booked after 22 weeks gestation or had missed over four antenatal appointments.
** Percentages have been rounded to the nearest whole percentage.
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