Maternal Death

Question 1

What is a maternal death?

Answer 1

Death of a woman

While pregnant

Or within 42 days of termination of pregnancy

Irrespective of duration and site of pregnancy

From any cause related to or aggravated by the pregnancy or its management

But not from accidental or incidental causes

Question 2

What is Sri Lanka’s maternal mortality rate?

Answer 2

33 per 100,000 live births

50% preventable

Question 3

What are the rough statistics on pregnancy outcomes in Sri Lanka?

Answer 3

48% Live birth

27 % IUD

12% Stillbirth

9% abortion or ectopic

Question 4

What are the statistics on places of death in maternal mortality?

Answer 4

90% hospital
(55% teaching hospital)

8% in transit

2% at home

Question 5

What are the preventable causes of maternal death?

Answer 5

Obstetric hemorrhage

Abortion and ectopic

Hypertension

Cardiopulmonary disease

Sepsis

Amniotic fluid embolism

DVT PE

Misoprostol overdose

Suicide

Question 6

What are the main types of maternal deaths?

Answer 6

Direct seqalue of pregnancy

Indirect due to underlying disease

Question 7

Why are maternal deaths investigated?

Answer 7

Identify cause

Rectify cause

Prevention

Question 8

What are the objectives of maternal death autopsy?

Answer 8

History from relatives/ others

Study clinical notes

Examine death scene

Autopsy findings

Identify cause of death

Report on all medicolegal issues

DO NOT FILL B33 DEATH DECLARATION

Question 9

What are the types of medicolegal inquiries into maternal death in Sri Lanka?

Answer 9

Maternal death review by FHB
(Fact finding)

Inquiries into maternal death by MOH
(Fault finding)

Judicial inquiry into sudden death by ISD or magistrate
(Fault finding)

Question 10

What are the direct causes of maternal death?

Answer 10

Uterine atony

Placental abruption

Placenta previa

PET

HELP

Abortion

Miscarriage

Ectopic rupture

Embolism

Peri partum dilated cardiomyopathy

Acute fatty liver of pregnancy

Sepsis