Schuitemaker N, van Roosmalen J, Dekker G, van Dongen P, van Geijn H, Bennebroek Gravenhorst J
Department of Obstetrics and Gynaecology, Diakonessenhuis Utrecht, The Netherlands.
Eur J Obstet Gynecol Reprod Biol. 1998 Jul;79(1):57-62. doi: 10.1016/s0301-2115(98)00053-0.
To determine the causes of maternal death in The Netherlands.
Nationwide Confidential Enquiry into the Causes of Maternal Deaths during the period 1983-1992.
Of 192 direct and indirect maternal deaths, 154 (80%) were available for the Enquiry. The most frequent direct causes were (pre-)eclampsia, thrombo-embolism, obstetrical haemorrhage and sepsis. Cerebro- and cardiovascular disorders were the most frequent indirect causes of death. Age above 35 years and parity 3 or more are related to higher maternal mortality. Women from non-caucasian origin are more prone to death in comparison to caucasian women. Autopsy was performed in 88 cases (57%). Of the 24 women where labour started at home, the place of birth played a significant role in delay in four.
More efforts should be made to have a higher percentage than 80% available for the Confidential Enquiry as in the UK where only 1-4% of deaths are not available for similar purposes. Also, the autopsy rate of 57% is much lower than in the UK (82%). Special strategies should be developed to improve maternal health of populations at higher risk such as women of high age and parity and immigrant populations.
确定荷兰孕产妇死亡的原因。
对1983年至1992年期间孕产妇死亡原因进行全国性保密调查。
在192例直接和间接孕产妇死亡病例中，有154例（80%）可供调查。最常见的直接原因是（先兆）子痫、血栓栓塞、产科出血和败血症。脑血管和心血管疾病是最常见的间接死亡原因。35岁以上及产次为3次或更多与孕产妇死亡率较高有关。与白人女性相比，非白人女性更容易死亡。88例（57%）进行了尸检。在24例在家中开始分娩的女性中，出生地在4例中对延误起到了重要作用。
应做出更多努力，使可供保密调查的比例高于80%，如在英国，只有1%至4%的死亡病例无法用于类似目的。此外，57%的尸检率远低于英国（82%）。应制定特殊策略，以改善高风险人群的孕产妇健康，如高龄和高产次女性以及移民人群。
