Abstract
Summary:Fifty‐six maternal deaths in 35,159 deliveries have been studied, with special regard to the mode of death in patients with severe toxaemia of pregnancy.Toxaemia (23), haemorrhage (11), infection (10), and cardiac disease (5), were the commonest causes of death.Maternal mortality was 1.62 per 1,000 live births.The mechanisms of death in patients with toxaemia were:(a) Acute circulatory failure– 11 patients.Evidence is presented to show that these patients exhibited features similar to those in patients dying from septic abortion, intra‐uterine infection in labour, and premature placental separation without toxaemia.It is suggested that all these deaths resulted from the manifestations of the generalized Shwartzman reaction in pregnancy.(b) Vascular accidents– 9 patients.These deaths were due mainly to disruption of major blood vessels. The wider use of hypotensive drugs to avoid such accidents is advocated.(c) Miscellaneous– 4 patients.This group consists of 2 patients with respiratory complications due to over‐treatment, 1 with pyaemia from a suppurative pyelonephritis and 1 sudden death after termination of pregnancy in a near‐uraemic patient.
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