Maternal deaths at the Armed Forces Hospital, Riyadh 1978-1989

An analysis of 11 maternal deaths during a period of 11 years, from December 1, 1978 to December 31, 1989, is presented. During this period there was a total of 42,265 maternities with a maternal mortality rate of 26 per 100,000 maternities. Three maternal deaths were attributed to "direct" obstetric causes, and eight deaths to "associated" causes. Hemorrhage was the leading cause of direct and indirect maternal deaths (4 cases), followed by cardiac disease (3 cases). The availability of antibiotics and blood transfusion, together with frequent morbidity and mortality meetings, have helped significantly to keep the incidence of maternal deaths from obstetrics causes to minimum and to eliminate abortion, infection, ectopic pregnancy, and molar gestation as causes of maternal death. Our particular concern is the high rate of preventable factors contributing to maternal mortality. These were present in 9 of the 11 maternal deaths. Greater effort is necessary to identify those patients with conditions that predispose to maternal death and to provide the appropriate care to reduce mortality to the absolute minimum. A step in the right direction would be the establishment of a National Maternity Mortality Survey to provide the data and information necessary for identifying and assessing the preventable factors contributing to maternal deaths.