CMACE Release: Saving Mothers' Lives Report - Reviewing Maternal Deaths 2006-2008, UK

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The overall number of maternal deaths in the UK has fallen over the last three years despite a rise in the number of women dying from infection ...

The maternal mortality rate was 11.39 per 100,000 maternities compared to 13.95 per 100,000 maternities for the previous triennium, 2003-05. As this enquiry is far more inclusive than in other countries, for direct comparison with international figures, the UK maternal death rate was 6.7 per 100,000 live births.

... The direct death rate decreased from 6.24 per 100,000 maternities in 2003-2005 to 4.67 per 100,000 maternities in 2006-2008. The leading cause was infection. Many of these deaths were from Group A Streptococcal disease caught in the community, mirroring a rise in the general population. The report calls for mothers and healthcare workers to be aware of the need for scrupulous hygiene especially after birth, and most importantly if new mothers are in contact with people with sore throats. It also calls for national guidelines to be drawn up for the identification and management of sepsis in pregnant and recently delivered women.

There has been a welcome, significant, decline in deaths from pulmonary embolism and to a lesser degree, haemorrhage, following the publication and implementation of guidelines that were recommended in previous reports ...

... "The reason why the maternal mortality rate in the UK is comparatively low is because we make every effort to understand and then act on the root causes of why some mothers die during and after pregnancy. Much hard work has been undertaken to produce these maternal enquiries. This eighth report has highlighted some of the successes over the last few years in preventing death but we must not become complacent. More needs to be done to ensure that maternal death is kept as low as possible."

... "This report has highlighted several key areas for those working in maternity services to heed, in particular, the need for GPs and midwives to identify women requiring specialist care and the need for quick referrals. These recommendations provide us with a snapshot of maternity services and are meant to help healthcare professionals improve standards of care."

... "Some of the areas which were identified in the previous report ... have been acted upon. Consequently, the follow-up ... shows the true impact of these maternal enquiries. They provide us with good data and help us to monitor trends so that we can prevent maternal death."

... The report provides 10 key recommendations for policy makers, service commissioners and providers and healthcare professionals:

- Pre-pregnancy counselling - Women with pre-existing medical illness ... should be informed of how this may relate to their pregnancy.

- Pre-existing medical conditions - Women whose pregnancies are likely to be complicated ... should be immediately referred to appropriate specialist centres where care can be optimised. Referrals should be made a priority.

- Specialist clinical care - There remains an urgent need for the routine use of a national modified early obstetric warning score (MEOWS) chart in all pregnant or postpartum women who become unwell and require either obstetric or gynaecology services. This will help in the recognition, treatment and referral of women who have, or are developing, a critical illness during or after pregnancy.

- Genital tract infection/sepsis - All pregnant and recently delivered women need to be informed of the risks and signs and symptoms of genital tract infection and how to prevent its transmission and all health care professionals should be aware of the signs and symptoms of sepsis ...

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