Maternal Mortality Revisited: The Underrecognized Burden of Incidental and Traumatic Deaths in a Forensic Autopsy...

Maternal deaths are among the most critical global health indicators and directly reflect the quality of obstetric care. In this context, it is crucial to define and evaluate maternal mortality accurately. The aim of this study was to identify the factors leading to maternal deaths, and to assess the burden of trauma-related deaths. The autopsies of maternal deaths conducted at the Morgue Department of the Ankara Group Presidency of the Council of Forensic Medicine between 2011 and 2025 were retrospectively recorded through the National Judicial Network system. A total of 63 cases were identified through keyword searches ("pregnant," "placenta," and "fetus"), and data pertaining to age, gestational age, parity, mechanism of trauma and autopsy findings were recorded. The mean age of the study group was 28.9±7.1 years. Direct obstetric deaths accounted for 20.6%, indirect obstetric deaths for 17.5%, and incidental maternal deaths for 47.6% of the cases. The cause of death remained undetermined in 14.3% of the cases. Maternal mortality has a heterogeneous and multifactorial structure. The high proportion of incidental deaths in forensic autopsy series suggests that evaluating maternal mortality solely within the framework of obstetric complications may be insufficient.