Ghalib Yassin Batool Ali, Hassan Al-Safi Aliaa Makki, Al-Saneed Enaam Hasson
Department of Family and Community Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq.
Maternal and Child Health Section in the Ministry of Health, Iraq.
Indian J Community Med. 2022 Apr-Jun;47(2):177-181. doi: 10.4103/ijcm.ijcm_571_21. Epub 2022 Jul 11.
Complications during pregnancy and childbirth are a leading cause of death and disability among women in developing countries. The target for mortality reduction is important, yet accurate data of maternal mortality remains challenging as reporting errors including misclassification of cause of death continue to pose a major challenge.
This study aimed to identify if there is any discrepancy between clinical and autopsy causes of maternal death.
A review of all maternal deaths records that had two sources for registered cause of death; one made by the obstetrician depending on clinical setting and the other by forensic medicine after autopsy and search for any discrepancies between the two sources.
A total of 468 maternal death reports were reviewed; the discrepancies were more with the second commonest cause of maternal death in Iraq which is pulmonary embolism. The review revealed that 10.1% of those clinically died because of pulmonary embolism turned to be dead from other causes; 8.7% of them from postpartum hemorrhage, and the rest from sepsis and other indirect causes.
There is a substantial discrepancy between clinical and autopsy causes of maternal death which necessitates asking for autopsy in cases of maternal mortality of uncertain cause. The use of maternal death review within 3-6 weeks of death as a tool to identify causes of maternal deaths is recommended.
妊娠和分娩期间的并发症是发展中国家女性死亡和残疾的主要原因。降低死亡率的目标很重要，但由于包括死因错误分类在内的报告错误仍然是一个重大挑战，孕产妇死亡率的准确数据仍然难以获取。
本研究旨在确定孕产妇临床死因与尸检死因之间是否存在差异。
回顾所有有两个死亡登记原因来源的孕产妇死亡记录；一个由产科医生根据临床情况确定，另一个由法医在尸检后确定，并查找这两个来源之间的任何差异。
共审查了468份孕产妇死亡报告；差异更多地体现在伊拉克孕产妇死亡的第二大常见原因即肺栓塞上。审查显示，临床诊断因肺栓塞死亡的病例中，有10.1%实际死于其他原因；其中8.7%死于产后出血，其余死于败血症和其他间接原因。
孕产妇临床死因与尸检死因之间存在显著差异，这就需要在死因不明的孕产妇死亡病例中进行尸检。建议在死亡3至6周内进行孕产妇死亡审查，以此作为确定孕产妇死亡原因的工具。
