In the light of quality assurance, the knowledge gained from this kind of study can improve the pregnancy outcome of future mothers. doi:. European Perinatal Health Report 2010 - Health and Care of Pregnant Women and Babies in Europe in 2010. Cardiovasc Diagn Ther. In the current study, as many as 30.8% of all indirect maternal deaths were a result of a cardiac pathology. PMID: 1525090 DOI: 10.1111/j.1471-0528.1992.tb13815.x Abstract PIP: There are various methods of measuring maternal mortality each with its own advantages and disadvantages. In the previous study period, there were two non-pregnancy-related suicides [4]. Although a reduction in maternal mortality due to haemorrhage compared to the previous study periods has been achieved, the incidence is still too high and further action is needed in this regard. The infant mortality rate for Switzerland in 2019 was 3.294 deaths per 1000 live births, a 2.23% decline from 2018. 15 World Health Organisation. The maternal mortality ratio, on the other hand, is the number of maternal deaths per … To allow comparison between other countries the direct and indirect MMRs were combined. Please check your download folder. 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. Among the 96 analysed cases, 60 women were of unknown nationality. For descriptive statistical analysis we used Fisher’s exact test to calculate odds ratios (ORs). 12.10.2020 Matern Child Health J. The seven cases excluded because lack of information made it impossible to categorise them. doi:. 2005;143(10):697–706. Core Indicators of the Health and Care of Pregnant Women and Babies in Europe in 2015. Additionally, autopsy reports were available in only 25% of all cases. In the current study, two cases were found in which a direct link to caesarean section seemed plausible and thus were used for the calculation of the lethality of a caesarean section. There was an overall increase in the number of maternal deaths analysed, as well as an increase in the number of indirect cases; however, an increase in direct maternal mortality was not observed. on behalf of MBRRACE-UK. doi:. To assess underreporting, the cases reported by the FSO that occurred in the canton of Zurich were compared with the cases in the archive of the IRM at the University of Zurich. 2018. In this study, maternal death due to thromboembolism was the third most common cause of death (0.38/100,000 live births). doi:. 14 Knight MNM, Tuffnell D, Kenyon S, Shakespeare J, Brocklehurst P, Kurinczuk JJ, eds. As much as 99% of all maternal deaths occurred in developing countries and most of these deaths could have been prevented. So, they were either not able or not willing to give a detailed report of the incident. Circulatory diseases account for a high number of indirect obstetric causes of deaths in Europe [10]. Please check your download folder. Perceived health status. The patient had a massive postpartum haemorrhage due to atonic uterus, unsuccessful administration of uterotonics and, despite an emergency hysterectomy, she died as a result of hypovolaemic shock (table 6). The country having obtained this data is : South Sudan The lowest data is : 2. In one indirect case, the woman had surgery for an ectopic pregnancy, developed heparin-induced thrombocytopenia and later died of thromboembolism. May 2013. Available from: EURO-PERISTAT Project, European Perinatal Health Report. All death certificates having an ICD-10 classification code in the obstetric field as well as all death certificates with the code “F53” (puerperal psychosis) were included. The search terms included “maternal mortality”, “maternal death” and “maternal morbidity”. In total, 149,601 live births were registered between 2005 and 2014 in the canton of Zurich, and eight deaths (four direct cases, four unrelated deaths) were reported by the FSO, resulting in a direct maternal mortality ratio of 2.67/100,000 live births. The median age of the women who committed suicide was 36.7 years. The maternal mortality rate in the west has dropped drastically in the last 100 years. 1). Lancet. Therefore, cases where death occurred within 365 days after delivery were included. 2019;134(4):881–2. As yet there are no detailed numbers of the actual causes of death for Switzerland. Allisyn C Moran, PhD . 2019. In the UK, the incidence of heart disease during pregnancy has remained constant at about 0.9%, but the rate of maternal deaths due to cardiac disease has increased progressively in the last 20 years [13], accounting for a maternal mortality ratio of 2.18 per 100,000 maternities from 2012 to 2014 [14]. © Monkey Business Images / Dreamstime.com, Katharina Quack Lötscher, MD, MPH, Clinic of Obstetrics, University Hospital Zurich, Frauenklinikstrasse 10, CH-8091 Zurich, katharina.quackloetscher[at]usz.ch, 1 Alkema L, Chou D, Hogan D, Zhang S, Moller A-B, Gemmill A, et al. 2019;134(4):881–2. Maternal mortality ratio (modeled estimate, per 100,000 live births) - Switzerland WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. As the graph below shows, over the past 17 years this indicator reached a maximum value of 13,900 in 2017 and a … Compared with the maternal mortality ratio of other European countries described in the EURO-PERISTAT report published in 2018, Switzerland has one of the lowest rates in Europe [10]. However, if all suicides had been classified as direct obstetric deaths in accordance with ICD-MM, then suicides would have been the leading cause of maternal deaths in Switzerland (table 4) and the direct MMR would be 5.0/100,000 live births. Due to improved monitoring strategies, an increase in maternal mortality was expected. Avoidable mortality. Maternal mortality ratio (national estimate, per 100,000 live births) - Switzerland, Russian Federation, United States The country data compiled, adjusted and used in the estimation model by the Maternal Mortality Estimation Inter-Agency Group ( MMEIG ). For an analysis of underreporting, cases from the Institute of Forensic Medicine (IRM), Zurich, were included. http://dx.doi.org/10.1016/j.ejogrb.2018.08.586 PubMed. Available from: https://www.bfs.admin.ch/bfs/de/home/aktuell/neue-veroeffentlichungen.assetdetail.11348164.html. Obstet Gynecol. +41 (0)61 467 85 55 Fax +41 (0)61 467 85 56 e-mail: Editorial office, EMH MediaSchweizerische ÄrztezeitungSwiss Medical ForumPrimary and Hospital CareCardiovascular MedicineSwiss Archives of Neurology, Psychiatry and PsychotherapySynapseSwiss Medical Informatics. Swiss Med Wkly. For the rates of amniotic fluid embolism, a reduction from the first to the second study period (0.74/100,000 to 0.64/100,000 live births) was observed, but no further decline in the amniotic fluid embolism rate since 2004 was observed [3, 4]. Perotto Laura, Zimmermann Roland, Quack Lötscher Katharina C. Klinik für Geburtshilfe, Universitätsspital Zürich, Switzerland. The main outcome of this study was to determine the ratios and causes of maternal mortality in Switzerland from 2004–2015 and to compare the results of this study period with the previously analysed study periods, including age and origin of the women. : maternal mortality, Switzerland, direct mortality, indirect mortality, non-pregnancy-related mortality. doi:. Pregnant women are five times more likely to develop venous thromboembolism than those who are not pregnant and therefore are at a higher risk for pulmonary embolism [21]. Increasing maternal age is a known risk factor for adverse outcomes in obstetrics, since it is often associated with other morbidities that are becoming more common in the childbearing population [12]. and by 40.4% compared with the MMR in 1985–1994 (5.54/100,000 live births, 45 cases; odds ratio [OR] 0.6, p = 0.04, 95% confidence interval [CI] 0.37–0.97). 2018;229:148–52. 2018;229:148–52. Communicable diseases. The risk for maternal mortality was significantly higher for women older than 35 years (OR 2.0, 95% CI 1.14–3.53) (table 5). 212: Pregnancy and Heart Disease. Main EK, Goffman D, Scavone BM, Low LK, Bingham D, Fontaine PL, et al. ; National Parternship for Maternal Safety; Council for Patient Safety in Women’s Health Care. doi:. This questionnaire covered personal anamnesis, family history, operations, prior pregnancies and deliveries, puerperium, mode of delivery, course of the pregnancy, fetal complications, and any available autopsy results. No further information on psychological status was available. Poor mental health during pregnancy or following delivery can have severe implications for maternal mortality. November 2018. In the UK, the incidence of heart disease during pregnancy has remained constant at about 0.9%, but the rate of maternal deaths due to cardiac disease has increased progressively in the last 20 years , accounting for a maternal mortality ratio of 2.18 per 100,000 maternities from 2012 to 2014 . on behalf of MBRRACE-UK. Classification of maternal deaths (ICD-10) and maternal mortality ratio. Reported risk factors for amniotic fluid embolisms include operative delivery (vaginal or caesarean), placenta praevia, placenta accreta and abruption, since in these situations an exchange of fluids between the maternal and fetal compartments is more likely [20]. The maternal mortality rate (MMR) has decreased by almost half within the European Region between 2000 to 2015, from 33 to 16 deaths per 100 000 live births respectively. Definitions and data sources 2016;387(10017):462–74. 2016. Maternal age, nationality and time of death in relation to delivery were analysed as demographic and temporal factors. Therefore, cases where death occurred within 365 days after delivery were included as well. 2014;18(7):1628–38. Maternal deaths should be considered “unexpected death” and therefore undergo autopsy. BMC Med. Maternal mortality after cesarean section in the Netherlands. From 1990 to 2015, global maternal mortality fell from 385/100,000 to 216/100,000 live births, a reduction of 43.9%. When reporting the death of a female aged 15–49 years, it is mandatory to mention in the death certificate whether the woman was pregnant at the time of her death or if she had given birth on any of the previous 42 days leading up to her death. Haemorrhage is still the leading cause of direct maternal mortality; the rate is similar to what it was in the early 1990s. Haemorrhage was classified as a direct obstetric case, except for one indirect case. Maternal mortality in Switzerland 1995-2004. Heslehurst N, Brown H, Pemu A, Coleman H, Rankin J. Perinatal health outcomes and care among asylum seekers and refugees: a systematic review of systematic reviews. The ethics committees of each participating canton approved this national cohort study (KEK Nr. Obstet Gynecol. http://dx.doi.org/10.1016/0002-9378(95)91474-9 PubMed, 21 Devis P, Knuttinen MG. Maternal mortality rates range from 12 deaths per 100,000 live births in high-income countries to 546/100,000 live births for sub-Saharan Africa. The infant mortality rate for Switzerland in 2020 was 3.219 deaths per 1000 live births, a 2.28% decline from 2019. 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. Lethality after caesarean section was 0.008‰ (2/231,385). 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