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Maternal deaths from hypertensive disorders: lessons learnt.

Lill T Nyfløt1,2, Liv Ellingsen3, Branka M Yli3

  • 1Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Oslo, Norway.

Acta Obstetricia Et Gynecologica Scandinavica
|April 18, 2018
PubMed
Summary

Hypertensive disorders in pregnancy remain a leading cause of maternal death in Norway. Improving antihypertensive treatment and delivery timing can prevent these tragic outcomes, as indicated by maternal death audits.

Keywords:
HELLPMaternal mortalityhigh risk pregnancyhypertension in pregnancyinduction of laborpreeclampsia

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal Health
  • Public Health

Background:

  • Hypertensive disorders in pregnancy are the leading cause of maternal mortality in Norway.
  • Substandard care is strongly linked to these deaths.
  • Successful guideline implementation in the UK suggests potential for similar reductions globally.

Purpose of the Study:

  • To prevent future maternal deaths from hypertensive disorders in pregnancy.
  • To identify suboptimal factors in the treatment of these conditions through maternal death audits.

Main Methods:

  • Analysis of maternal deaths in Norway from 1996 to 2014 using linked registries.
  • Case assessments by the Norwegian Maternal Mortality Audit Group, focusing on cause of death, treatment evaluation, and care quality.
  • Emphasis on antihypertensive treatment, delivery timing, and pre-delivery stabilization.

Main Results:

  • Identified 74 maternal deaths, with hypertensive disorders being the most common cause (16 deaths).
  • Maternal mortality rate was 6.5 deaths per 100,000 live births.
  • Improvements in care could have altered the outcome in 87% of deaths attributed to hypertensive disorders.

Conclusions:

  • Hypertensive disorders were the primary cause of maternal death in Norway between 1996 and 2014.
  • Maternal deaths due to these conditions are preventable.
  • Enhancements in antihypertensive treatment and delivery timing are crucial for improving outcomes.