Norwegian Research center for Women's Health, Oslo University Hospital, Oslo, Norway.
Department of Obstetrics, Drammen Hospital, Drammen, Norway.
Acta Obstet Gynecol Scand. 2021 Jul;100(7):1273-1279. doi: 10.1111/aogs.14104. Epub 2021 Feb 21.
Cardiovascular diseases have become increasingly important as a cause of maternal death in the Nordic countries. This is likely to be associated with a rising incidence of pregnant women with congenital and acquired cardiac diseases. Through audits, we aim to prevent future maternal deaths by identifying causes of death and suboptimal factors in the clinical management.
Maternal deaths in the Nordic countries from 2005 to 2017 were identified through linked registers. The national audit groups performed case assessments based on hospital records, classified the cause of death, and evaluated the standards of clinical care provided. Key messages were prepared to improve treatment.
We identified 227 maternal deaths, giving a maternal mortality rate of 5.98 deaths per 100 000 live births. The most common cause of death was cardiovascular disease (n = 36 deaths). Aortic dissection/rupture, myocardial disease, and ischemic heart disease were the most common diagnoses. In nearly 60% of the cases, the disease was not recognized before death. In more than half of the deaths, substandard care was identified (59%). In 11 deaths (31%), improvements to care that may have made a difference to the outcome were identified.
Between 2005 and 2017, cardiovascular diseases were the most common causes of maternal deaths in the Nordic countries. There appears to be a clear potential for a further reduction in these maternal deaths. Increased awareness of cardiac symptoms in pregnant women seems warranted.
心血管疾病已成为北欧国家产妇死亡的重要原因。这可能与患有先天性和后天性心脏疾病的孕妇发病率上升有关。通过审核，我们旨在通过识别死亡原因和临床管理中的不足之处，防止未来的产妇死亡。
通过链接登记册，确定了 2005 年至 2017 年期间北欧国家的产妇死亡病例。国家审核组根据医院记录进行病例评估，对死亡原因进行分类，并评估所提供的临床护理标准。编写关键信息以改进治疗。
我们确定了 227 例产妇死亡病例，每 100000 例活产中有 5.98 例产妇死亡。最常见的死亡原因是心血管疾病（36 例死亡）。主动脉夹层/破裂、心肌疾病和缺血性心脏病是最常见的诊断。在近 60%的病例中，疾病在死亡前未被识别。在超过一半的死亡病例中，发现了护理标准不达标（59%）。在 11 例死亡（31%）中，确定了可能对结果产生影响的护理改进措施。
2005 年至 2017 年期间，心血管疾病是北欧国家产妇死亡的最常见原因。这些产妇死亡似乎还有明显的进一步降低的空间。提高对孕妇心脏症状的认识似乎是合理的。
