Maternal Death and Its Investigation

Maternal deaths are a leading cause of death in young females worldwide, particularly in developing countries. Maternal mortality ratio, the number of maternal deaths per 100 000 live births, averages 240 in developing regions, but only 16 in developed regions. Causes of maternal and pregnancy-related deaths can be subdivided into three broad categories. Direct maternal deaths result from obstetric complications of the pregnant state (i.e., pregnancy, labor, and puerperium) from interventions, omissions, incorrect treatment, or from a chain of events resulting from any of the above. Indirect maternal deaths result from previously existing diseases or diseases that developed during pregnancy, and which are not due to a direct obstetric cause, but are aggravated by the physiologic effects of pregnancy. Incidental maternal deaths are those from causes unrelated to pregnancy or the puerperium, including accidental deaths and homicide. Maternal deaths carry significant short- and long-term impacts for family members and the role of the pathologist is an important part of the wider knowledge-gathering process that can contribute to changes in maternal mortality rates. This paper reviews the clinical and pathological features of common pregnancy-related disorders and gives guidelines for performing an autopsy related to maternal death.