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. 2009 Mar;104(3):194-8.
doi: 10.1016/j.ijgo.2008.10.031. Epub 2008 Dec 10.

Maternal mortality due to cardiac disease in Sri Lanka

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Maternal mortality due to cardiac disease in Sri Lanka

Hasanthi R Haththotuwa et al. Int J Gynaecol Obstet. 2009 Mar.

Abstract

Objective: To investigate Sri Lankan maternal deaths due to heart disease and to consider low-cost interventions to reduce these deaths.

Methods: A qualitative study based on retrospective audit of all maternal deaths and late maternal deaths in Sri Lanka caused by cardiac disease in 2004.

Results: A total of 145 maternal deaths were recorded in 2004, for a maternal mortality rate of 38 per 100,000. There were 42 indirect deaths, 25 of which were due to cardiac disease; 23 deaths had a specific cardiac cause listed. Standard care was identified in prepregnancy counseling, contraception, and prenatal community and specialist care.

Conclusion: Cardiac disease is a major cause of maternal mortality in Sri Lanka, second only to postpartum hemorrhage. Rheumatic mitral valve disease is responsible for more than a third of maternal deaths from cardiac disease. Substandard care was identified in all cases; strategies to improve care could allow a reduction in maternal cardiac deaths.

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