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Assessment of Maternal Vascular Remodeling During Pregnancy in the Mouse Uterus
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Published on: December 5, 2015

Rise in maternal mortality in the Netherlands.

J M Schutte1, E A P Steegers, N W E Schuitemaker

  • 1Department of Obstetrics and Gynaecology, Isala Klinieken Zwolle, Dr Van Heesweg 2, Zwolle, the Netherlands. jokeschutte@yahoo.nl

BJOG : an International Journal of Obstetrics and Gynaecology
|December 1, 2009
PubMed
Summary

Maternal mortality in the Netherlands has significantly increased, with pre-eclampsia being the leading cause. Early identification of high-risk pregnancies and improved professional training are crucial for better maternal health outcomes.

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Area of Science:

  • Obstetrics and Gynecology
  • Public Health
  • Epidemiology

Background:

  • Maternal mortality trends and causes require ongoing assessment to improve obstetric care.
  • Understanding substandard care factors is essential for targeted interventions in maternal health.

Purpose of the Study:

  • To analyze trends and identify causes of maternal mortality in the Netherlands between 1993 and 2005.
  • To determine factors contributing to substandard care in maternal deaths.

Main Methods:

  • A confidential inquiry into the causes of maternal mortality was conducted nationwide in the Netherlands.
  • Data from 2,557,208 live births were analyzed for maternal deaths occurring from 1993 to 2005.

Main Results:

  • The maternal mortality ratio increased significantly from 9.7 (1983-1992) to 12.1 per 100,000 live births (1993-2005).
  • Key direct causes included pre-eclampsia, thromboembolism, and sepsis; indirect deaths rose due to cardiovascular disorders.
  • Higher risk was observed in younger (<20) and older (>45) women, those with high parity, and non-western immigrant populations, with substandard care noted in 91% of pre-eclampsia cases and 62% of immigrant cases.

Conclusions:

  • Maternal mortality has risen in the Netherlands, with pre-eclampsia remaining the primary cause.
  • Improved identification of high-risk pregnancies before or early in gestation is needed, alongside preconception advice and increased antenatal visits.
  • Enhanced education for women and professionals on danger signs, coupled with professional training, is urgently required to improve maternal healthcare.