The physician who had signed the death certificate, or the corresponding clinic, was asked to complete an anonymous questionnaire on further information on the circumstances of the deaths. There are several limitations to address in this study. In the group of 26 direct obstetric deaths, 5 women died during pregnancy, 20 women gave birth and in 1 case it was not clear at which point death had occurred. Available from: Moussa HN, Rajapreyar I. ACOG Practice Bulletin No. Nonetheless, maternal deaths still occur during this period and are tragic. Perotto Laura, Zimmermann Roland, Quack Lötscher Katharina C. Klinik für Geburtshilfe, Universitätsspital Zürich, Switzerland. Header image: The maternal mortality rate in the west has dropped drastically in the last 100 years. 2015;126(1):155–62. In five cases, the women died because of uterine atony. ALL-CAUSE MORTALITY RATE This chart shows the decline in mortality rate at every age range. Therefore, cases where death occurred within 365 days after delivery were included as well. Harvard Chan School Center of Excellence in Maternal and Child Health 677 Huntington Avenue Boston, MA 02115 MHTF@hsph.harvard.edu This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant T76MC00001 and entitled Training Grant in Maternal and Child Health. If the suicide cases are included in the direct mortality, the ratio would be 5.0/100,000 live births (table 4). 2017;7(S3, Suppl 3):S309–19. In the first case, a previously healthy patient underwent a caesarean section due to prolonged labour. Since 2007, the FSO links birth data with the date of death of the mother, thus allowing women who had given birth in the year before their death to be identified. In this study, we analysed maternal mortality cases between 2005 and 2014 in Switzerland and compared them with those in earlier periods. Available from: www.europeristat.com. In one case, the time of death could not be determined. In the last 30 years, a slight reduction in amniotic fluid embolism from the first to the second study period was observed (fig. ; National Parternship for Maternal Safety; Council for Patient Safety in Women’s Health Care. A nonsignificant decrease in MMR due to infection was observed between the first and the second study periods (1985–1994: 1.1/100,000 live births, 1995–2004: 0.26/100,000) and has been unchanged since then [3, 4]. In 13 cases, death was classified as suicide. Since one of the main outcomes was to draw a comparison between this study and its preceding studies, where this practice was not yet in place, we decided to classify by ICD-10. The ethics committees of each participating canton approved this national cohort study (KEK Nr. ; United Nations Maternal Mortality Estimation Inter-Agency Group collaborators and technical advisory group. The WHO application of ICD-10 to deaths during pregnancy, childbirth and puerperium: ICD MM. Bundesamt für Statistik. In the UK also, the maternal mortality ratio due to hypertensive disorders of pregnancy has significantly decreased [14]. Manila: WHO Regional Office for the Western Pacific; 2016. 2005;143(10):697–706. The third most common cause of direct obstetric death was thromboembolism (0.38/100,000 live births), accounting for almost 12% of all direct maternal deaths. NOTE: The information regarding Maternal mortality rate on this page is re-published from the CIA World Factbook 2017. A confidential enquiry board does not exist in Switzerland. Available from: EURO-PERISTAT Project with SCPE and EUROCAT. In the two earlier studies, the lethality after caesarean section was 0.02‰ (1995–2004) and 0.09‰ (1985–1994), resulting in a reduction of 57% (p = n.s.) However, immediate action is still needed to further reduce the rate of haemorrhage that leads to maternal deaths. Backlinks from other websites and blogs are the lifeblood of our site and are our primary source of new traffic. Devis P, Knuttinen MG. (Obstetric death of unspecified cause), The number of maternal deaths during a given time period per 100,000 live births during the same time period, Deaths resulting from obstetric complications in the pregnant state (pregnancy, labour and puerperium), from interventions, omissions, incorrect treatment, or from a chain of events resulting from any of the above, Deaths resulting from previously existing disease, or any disease that developed during pregnancy and was not the result of direct obstetric causes, but which was aggravated by the physiological effects of pregnancy, Deaths from unrelated causes which happen to occur in pregnancy or the puerperium, Deaths occurring between 42 days and 1 year after abortion, miscarriage or delivery that are due to direct or indirect maternal causes. Neonatal mortality rate of Switzerland fell gradually from 10.7 deaths per 1,000 live births in 1970 to 2.8 deaths per 1,000 live births in 2019. Almost all maternal deaths (99%) occur in developing countries. In our study, we investigated the 10-year period between 2005 and 2014, having been preceded by two papers analysing the timespan from 1985 to 2004 [3, 4]. European Perinatal Health Report 2010 - Health and Care of Pregnant Women and Babies in Europe in 2010. 2018. Swiss Medical Weekly EMH Swiss Medical Publishers Ltd. Farnsburgerstrasse 8 CH-4132 Muttenz Tel. 26 - Aktuelle Therapieoptionen der postpartalen Hämorrhagie. 1 Maternal Health and Safe Motherhood Programme, World Health Organization, Geneva, Switzerland. This is likely owing to improved clinical care, as well as to the fact that a large proportion of the additionally analysed deaths were non-pregnancy-related maternal deaths. Although the mode of delivery was unknown in 42 cases, more than two thirds of those cases were non-pregnancy-related deaths. The current study did not analyse the distribution of nationalities because of limited data on nationality. For classifying the lethality of caesarean section, the death had to be temporally linked to the operation and the cause of death needed to be directly related to surgery [5]. http://dx.doi.org/10.1097/AOG.0000000000003497 PubMed, 12 Creanga AA, Berg CJ, Syverson C, Seed K, Bruce FC, Callaghan WM. 2016. and 90% (OR 0.09, p<0.05, 95% CI 0.02–0.42), respectively [3, 4]. The maternal mortality ratio in developing countries in 2015 is 239 per 100 000 live births versus 12 per 100 … http://dx.doi.org/10.1016/0002-9378(95)91474-9 PubMed, 21 Devis P, Knuttinen MG. Knight MBK, Tuffnell D, Jayakody H, Shakespeare J, Kotnis R, Kenyon S, et al., eds. In one indirect case, the woman had surgery for an ectopic pregnancy, developed heparin-induced thrombocytopenia and later died of thromboembolism. Immediate action is needed in a bid to meet the Sustainable Development Goals (SDG) target to reduce the global maternal mortality ratio to less than 70/100,000 live births by 2030 [2]. Am J Obstet Gynecol. Although overall mortality has reduced in the last 30 years, the number of women dying as a result of haemorrhage still accounts for roughly 35% of all direct maternal deaths (table 4). Since that increase, a reduction in maternal mortality due to haemorrhage has occurred (fig. 2014;18(7):1628–38. 12.10.2020 This could be attributed to the fact that the inclusion criteria and recording of maternal mortality cases have improved. A further limitation was the small numbers used for analysis as a result of missing data (e.g., mode of delivery), which made it difficult to obtain statistically significant results. 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