Abstract
BackgroundThromboembolism is one of the main causes of maternal mortality, which can be prevented in many cases. The present study was designed to investigate the incidence and prophylaxis strategies for maternal mortality following thromboembolism in postnatal.MethodsIn this case series study, the data of the mortality cases were extracted according to the ethical and security standards of the Ministry of Health of the country and compared with a healthy control group. The thromboembolism risk factors measured and scored using a questionnaire entitled “the evaluation of risk factors for maternal mortality following thromboembolism during pregnancy, labor, or post-partum”.ResultsThe maternal mortality rate was 16 per 100,000 live births. Among 297 mortality cases, 27 (9%) death were due to thromboembolism. The mean gestational age was 32.5 weeks. Dyspnea (88.8%) and tachycardia (18.5%) were found as common clinical manifestations in these patients. Sixteen cases (59.3%) did not get heparin, 6 (22.2%) received single dose and 5 (18.5%) received two doses and more. In these 11 cases, 5 (45%) patients received heparin before surgery, 1 after surgery, and 5 before and after surgery. Twenty cases deceased in the first hours after delivery and the rest after 2 to 12 days. The average score of risk for thromboembolism based on Royal College of Obstetricians & Gynecologist (RCOG) guideline was 4.6.ConclusionIt seems that one of the most important cause of maternal mortality in this study was the lack of recognition of high-risk patients and the lack of prescription for prophylaxis with heparin and this clearly explains the need for accurate screening of high-risk mothers, designing a standard form and the care and treatment of these patients.
Highlights
Maternal mortality is one of the greatest tragedies with wide ranging consequences for the family and society [1]
Materials and methods In this retrospective study cases with thromboembolism coded as the underlying or contributory cause of death in women aged 15–44 from March 2017 to February 2018 were evaluated. This national data was obtained from ministry of health which records maternal mortality statistics throughout the country, no case would miss in this era
Among 297 mortality cases in 1 year, 27 deaths were due to thromboembolism
Summary
Maternal mortality is one of the greatest tragedies with wide ranging consequences for the family and society [1]. It is an important public health indicator that reflects both the quality of health care services and the women’s status [2, 3]. Reduction of maternal mortality serves as one of the most important international development goals [4]. Iran has experienced a transition pattern in its major causes of maternal mortality and morbidity from those characteristics of developing nations such as hemorrhage and infection to causes more commonly seen in developed nations including thromboembolism, cardiac diseases [6,7,8] and in not rare condition, post-operative complications [9]. The present study was designed to investigate the incidence and prophylaxis strategies for maternal mortality following thromboembolism in postnatal
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