Best practice & research. Clinical obstetrics & gynaecology
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Best Pract Res Clin Obstet Gynaecol · Jun 2008
Maternal deaths due to hypertensive disorders in pregnancy.
Hypertensive disorders of pregnancy (HDP) are one of the most common direct causes of maternal mortality worldwide. Cerebral haemorrhage is the main final cause of hypertensive deaths and probably implies that doctors are reluctant to treat sustained high blood pressure effectively during pregnancy. Maternal deaths from HDP can probably be reduced markedly by: (1) promoting antenatal care and instituting a recall system for defaulters; (2) instituting regional centres and regional obstetricians to provide advice on, or care for, women with severe pre-eclampsia; (3) educating health professionals through continuing professional education and the use of clinical guidelines of management; and (4) informing the general public on complications associated with the pre-eclampsia/eclampsia syndrome.
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Best Pract Res Clin Obstet Gynaecol · Jun 2008
Maternal mortality in well-resourced countries: is there still a need for confidential enquiries?
The low maternal mortality rates in well-resourced countries are not an automatic consequence of prosperity. Morbidity cannot be avoided and preventing mortality requires good medical care. Now that deaths are infrequent in these countries, people expect investigation of every case and action to make pregnancy even safer. ⋯ Analysis is by practising clinicians from many specialties and recommendations are disseminated to clinicians, managers, politicians and the public. The confidential enquiry method has now been adopted by other specialties and by many countries. In countries without confidential enquiries there is under-reporting of maternal mortality, particularly among the poor.