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. 2016 Mar 21;6(3):e010304.
doi: 10.1136/bmjopen-2015-010304.

Current status of pregnancy-related maternal mortality in Japan: a report from the Maternal Death Exploratory Committee in Japan

Junichi Hasegawa  1 , Akihiko Sekizawa  2 , Hiroaki Tanaka  3 , Shinji Katsuragi  4 , Kazuhiro Osato  3 , Takeshi Murakoshi  5 , Masahiko Nakata  6 , Masamitsu Nakamura  2 , Jun Yoshimatsu  7 , Tomohito Sadahiro  8 , Naohiro Kanayama  9 , Isamu Ishiwata  10 , Katsuyuki Kinoshita  11 , Tomoaki Ikeda  3 ; Maternal Death Exploratory Committee in Japan; Japan Association of Obstetricians and Gynecologists
Affiliations

Current status of pregnancy-related maternal mortality in Japan: a report from the Maternal Death Exploratory Committee in Japan

Junichi Hasegawa et al. BMJ Open. .

Abstract

Objective: To clarify the problems related to maternal deaths in Japan, including the diseases themselves, causes, treatments and the hospital or regional systems.

Design: Descriptive study.

Setting: Maternal death registration system established by the Japan Association of Obstetricians and Gynecologists (JAOG).

Participants: Women who died during pregnancy or within a year after delivery, from 2010 to 2014, throughout Japan (N=213).

Main outcome measures: The preventability and problems in each maternal death.

Results: Maternal deaths were frequently caused by obstetric haemorrhage (23%), brain disease (16%), amniotic fluid embolism (12%), cardiovascular disease (8%) and pulmonary disease (8%). The Committee considered that it was impossible to prevent death in 51% of the cases, whereas they considered prevention in 26%, 15% and 7% of the cases to be slightly, moderately and highly possible, respectively. It was difficult to prevent maternal deaths due to amniotic fluid embolism and brain disease. In contrast, half of the deaths due to obstetric haemorrhage were considered preventable, because the peak duration between the initial symptoms and initial cardiopulmonary arrest was 1-3 h.

Conclusions: A range of measures, including individual education and the construction of good relationships among regional hospitals, should be established in the near future, to improve primary care for patients with maternal haemorrhage and to save the lives of mothers in Japan.

Keywords: DIC; amniotic fluid embolism; maternal death; maternal mortality; postpartum hemorrhage.

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Figures

Figure 1
Figure 1
Distribution of the durations between the initial symptoms and the initial cardiopulmonary arrest stratified by the major causes of maternal death, including obstetric haemorrhage (red bars), amniotic fluid embolism (green bars), brain disease (purple bars) and cardiovascular disease (blue bars).
Figure 2
Figure 2
The number of maternal deaths of each cause stratified by preventability.
See this image and copyright information in PMC

References

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