Bødker Birgit, Hvidman Lone, Weber Tom, Møller Margrethe, Aarre Annette, Nielsen Karen Marie, Sørensen Jette Led
Department of Obstetrics and Gynecology, Hillerød Hospital, Hillerød, Denmark.
Acta Obstet Gynecol Scand. 2009;88(5):556-62. doi: 10.1080/00016340902897992.
To describe a method for identification, classification and assessment of maternal deaths in Denmark and to identify substandard care.
Register study and case audit based on data from the Registers of the Danish Medical Health Board, death certificates and hospital records.
Denmark 2002-2006.
Women who died during a pregnancy or within 42 days after a pregnancy.
Maternal deaths were identified by notification from maternity wards and data from the Danish National Board of Health. A national audit committee assessed hospital records of direct and indirect deaths.
Maternal mortality ratio, causes of death and suboptimal care.
In the study period, 26 women died during pregnancy or within 42 days from direct or indirect causes, leading to a maternal mortality ratio of 8.0/100,000 live births. Causes of death were cardiac disease, thromboembolism, hypertensive disorders of pregnancy, Streptococcus A infections, suicide, amniotic fluid embolism, cerebrovascular hemorrhage, asthma and diabetes.
Our method proved valid and can be used for future research. Causes of death could be identified and learning points from the assessments could form the basis of focused education and guidelines. Future complementary 'near miss' studies and cooperation with other countries with comparable health systems are expected to improve the benefits of the enquiries, contributing to improved management of life-threatening conditions in pregnancy and childbirth.
描述丹麦孕产妇死亡的识别、分类和评估方法，并识别不合格护理情况。
基于丹麦医疗健康委员会登记册、死亡证明和医院记录数据的登记研究及病例审核。
丹麦，2002 - 2006年。
孕期或妊娠结束后42天内死亡的女性。
通过产科病房的通报以及丹麦国家卫生局的数据识别孕产妇死亡情况。一个国家审核委员会评估直接和间接死亡的医院记录。
孕产妇死亡率、死亡原因及护理欠佳情况。
在研究期间，26名女性在孕期或42天内死于直接或间接原因，孕产妇死亡率为8.0/10万活产。死亡原因包括心脏病、血栓栓塞、妊娠高血压疾病、A组链球菌感染、自杀、羊水栓塞、脑血管出血、哮喘和糖尿病。
我们的方法被证明是有效的，可用于未来的研究。能够识别死亡原因，评估中的经验教训可为重点教育和指南奠定基础。未来开展补充性“near miss”研究并与其他卫生系统类似的国家合作，有望提高调查的效益，有助于改善对危及孕产妇生命情况的管理。
