In 16 cases, death occurred during pregnancy. All obstetric deaths were classified by available information in keeping with the ICD-10 classifications into “direct”, “indirect”, “late”, and “pregnancy-independent” maternal death categories (table 2). Curr Opin Obstet Gynecol. We examined the under-5 mortality rate (U5MR) and maternal mortality ratio (MMR) as the outcome variables since these indicators are used by the UN to monitor progress towards MDG 4 and 5. Compared with the previous study period (1995–2004), a reduction in maternal mortality due to haemorrhage has been achieved. The UN estimates there were around 140 million births in 2015. Knight MNM, Tuffnell D, Kenyon S, Shakespeare J, Brocklehurst P, Kurinczuk JJ, eds. The Federal Statistical Office (FSO) provided maternal death certificates for the years 2005 to 2014. Amniotic fluid embolism and preeclampsia were classified as direct obstetric cases. Kallianidis AF, Schutte JM, van Roosmalen J, van den Akker T; Maternal Mortality and Severe Morbidity Audit Committee of the Netherlands Society of Obstetrics and Gynecology. - Maternal mortality ratio (per 100,000 live births): 5 (#165 highest) ... - Mortality rate attributed to household and ambient air pollution (per 100,000 people): 20 (#153 highest) ... Switzerland's health-care system is one of the best in the world. and by 40.4% compared with that in 1985–1994 (5.54/100,000) (OR 0.6, 95% CI 0.37–0.97; p = 0.04). http://dx.doi.org/10.7326/0003-4819-143-10-200511150-00006 PubMed, 23 Pedersen GS, Grøntved A, Mortensen LH, Andersen AM, Rich-Edwards J. Maternal mortality among migrants in Western Europe: a meta-analysis. In the current study, 79 women gave birth, among whom 24 (30.4%) had caesarean sections, but the delivery mode was unknown in 42 cases. Reported risk factors for amniotic fluid embolisms include operative delivery (vaginal or caesarean), placenta praevia, placenta accreta and abruption, since in these situations an exchange of fluids between the maternal and fetal compartments is more likely [20]. Saving Lives, Improving Mothers’ Care - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2014-16. The lethality after caesarean section was 0.0086‰ (2/231,385). doi:. Matern Child Health J. Women with permanent residence in Switzerland, those who died in Switzerland or abroad, and those who died in Switzerland but were not residing permanently in Switzerland were included in the study. Am J Obstet Gynecol. Obstet Gynecol. Here we assume a global maternal mortality rate of 8 per 100,000 live births in 2015. In the group of 26 direct obstetric deaths, 5 women died during pregnancy, 20 women gave birth and in 1 case it was not clear at which point death had occurred. We have provided a few examples below that you can copy and paste to your site: Your image export is now complete. To analyse the influence of maternal age on the mortality ratio four groups were formed: <25 years, 25–29 years, 30–34 years and ≥35 years. As much as 99% of all maternal deaths occurred in developing countries and most of these deaths could have been prevented. Maternal mortality ratio (national estimate, per 100,000 live births) - Switzerland, Russian Federation, United States The country data compiled, adjusted and used in the estimation model by the Maternal Mortality Estimation Inter-Agency Group ( MMEIG ). 2018;16(1):89. doi:. Here we assume a global maternal mortality rate of 900 per 100,000 live births in 2015. Two women died of ectopic pregnancy, and two women died in relation to a ruptured uterus. Maternal mortality ratio , 2010, Lifetime risk of maternal death (1 in:) 9500. doi:. As 787,025 live births were recorded between 2005 and 2014 in Switzerland, the direct MMR was 3.30/100,000 live births (26 cases). On the first postoperative day she complained of shortness of breath and her general state deteriorated. This included one direct, one indirect, all 11 postpartum suicides and 29 non-pregnancy-related deaths. doi:. Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births [poster]. This is likely owing to improved clinical care, as well as to the fact that a large proportion of the additionally analysed deaths were non-pregnancy-related maternal deaths. One additional case was found by searching the archive of the IRM. This is a result of the reduced rates of hypertensive disorders, thromboembolism, infections and anaesthesia-related complications. Deep venous thrombosis in pregnancy: incidence, pathogenesis and endovascular management. (Obstetric death of unspecified cause), The number of maternal deaths during a given time period per 100,000 live births during the same time period, Deaths resulting from obstetric complications in the pregnant state (pregnancy, labour and puerperium), from interventions, omissions, incorrect treatment, or from a chain of events resulting from any of the above, Deaths resulting from previously existing disease, or any disease that developed during pregnancy and was not the result of direct obstetric causes, but which was aggravated by the physiological effects of pregnancy, Deaths from unrelated causes which happen to occur in pregnancy or the puerperium, Deaths occurring between 42 days and 1 year after abortion, miscarriage or delivery that are due to direct or indirect maternal causes. The maternal mortality rate in the west has dropped drastically in the last 100 years. Amniotic fluid embolism: analysis of the national registry. In all other direct cases, caesarean sections were due to pre-existing pregnancy-related diseases or conditions that were further aggravated during pregnancy: preeclampsia/HELLP (n = 3) and placental abruption (n = 2). The combined MMR was 6.61/100,000 live births (OR 4.8–8.4). Maternal mortality has decreased by 20.5% compared with that in 1995–2004 (4.15/100,000) (OR 0.8, 95% CI 0.47–1.33; p = n.s.) 2019;221(4):295–303. 2 World Health Organization. Haemorrhage was classified as a direct obstetric case, except for one indirect case. In one case, information was not provided as it was subject to an ongoing legal case. Thromboembolisms were classified as direct obstetric cases, except for three cases that were classified as indirect cases. 2010;140(1-2):25–30. Alkema L, Chou D, Hogan D, Zhang S, Moller A-B, Gemmill A, et al. 3 Meili G, Huch R, Huch A, Zimmermann R. Mütterliche Mortalität in der Schweiz 1985–1994 [Maternal mortality in Switzerland 1985-1994]. 14 Knight MNM, Tuffnell D, Kenyon S, Shakespeare J, Brocklehurst P, Kurinczuk JJ, eds. The infant mortality rate for Switzerland in 2019 was 3.294 deaths per 1000 live births, a 2.23% decline from 2018. 2005;143(10):697–706. In this group, 13 women committed suicide and 8 women died of complications of pre-existing cardiac pathologies. All suggestions for corrections of any errors about Maternal mortality rate should be addressed to the CIA. Design and layout by L’IV Com Sàrl, Villars-sous-Yens, Switzerland. © Monkey Business Images / Dreamstime.com, Katharina Quack Lötscher, MD, MPH, Clinic of Obstetrics, University Hospital Zurich, Frauenklinikstrasse 10, CH-8091 Zurich, katharina.quackloetscher[at]usz.ch, 1 Alkema L, Chou D, Hogan D, Zhang S, Moller A-B, Gemmill A, et al. The Swiss Society of Gynaecology and Obstetrics (SGGG) notes that in most situations action taken was too little and too late, with an unfavourable outcome [17]. In five cases, the women died because of uterine atony. Direct maternal mortality in Switzerland 1985–2014. ... Indicator 3.4.2 Suicide mortality rate..... 61 Indicator 3.5.2 Alcohol use ... MMR maternal mortality ratio. The questionnaires sent to the involved clinics were usually filled out by physicians who were not involved in the analysed case. If you use our chart images on your site or blog, we ask that you provide attribution via a link back to this page. Although the mode of delivery was unknown in 42 cases, more than two thirds of those cases were non-pregnancy-related deaths. Regional Office for the Western P. Sustainable development goals (SDGs): Goal 3. We would like to thank all the doctors in the different hospitals or other medical settings that helped to gather the information on individual cases. If you use our datasets on your site or blog, we ask that you provide attribution via a link back to this page. 2017;7(S3, Suppl 3):S309–19. Core Indicators of the Health and Care of Pregnant Women and Babies in Europe in 2015. Therefore, cases where death occurred within 365 days after delivery were included as well. Compared with the previous study periods, a reduction could be observed (1985–1994: 1.23/100,000 live births vs 2005–2014: 0.64/100,000 live births, p = n.s.) In 42 cases, the mode of delivery was not known. The data were compared with the information provided by the FSO. and by 40.4% compared with the MMR in 1985–1994 (5.54/100,000 live births, 45 cases; odds ratio [OR] 0.6, p = 0.04, 95% confidence interval [CI] 0.37–0.97). Cause of death in relation to caesarean section (vaginal deliveries = 67.9% of 787,007 live births). http://dx.doi.org/10.1016/j.ajog.2019.02.056 PubMed. 212: Pregnancy and Heart Disease. Among the 20 women that gave birth, 7 had spontaneous vaginal deliveries, 3 had vaginal operative deliveries, 9 had caesarean sections, and in 1 case it was not known how the woman had delivered. The maternal mortality ratio, on the other hand, is the number of maternal deaths per … 2018. 1995;172(4 Pt 1):1158–67, discussion 1167–9. Lebendgeburten nach Alter der Mutter 2018. doi:. ... (LiST) including 2017 maternal mortality ratio estimates, 2018 neonatal mortality rate estimates, and 2015 stillbirth rate estimates. Maternal mortality by maternal age in Switzerland 2005–2014. Cardiovasc Diagn Ther. Pregnancy-related mortality in the United States, 2006-2010. Keywords: Together with amniotic fluid embolism, preeclampsia/HELLP was found to be the second leading cause of maternal mortality in Switzerland, each accounting for almost 20% of all direct obstetric deaths (0.64/100,000 live births). The direct maternal mortality rate (MMR), and indirect and combined MMRs were calculated. 16 Mangla K, Hoffman MC, Trumpff C, O’Grady S, Monk C. Maternal self-harm deaths: an unrecognized and preventable outcome. Compared with the maternal mortality ratio of other European countries described in the EURO-PERISTAT report published in 2018, Switzerland has one of the lowest rates in Europe [10]. The leading cause for direct maternal mortality in the current study period was haemorrhage (nine cases), followed by amniotic fluid embolisms and preeclampsia (five cases each). 2003;43(3):158–65. As the graph below shows, over the past 17 years this indicator reached a maximum value of 13,900 in 2017 and a … The maternal mortality rate (MMR) has decreased by almost half within the European Region between 2000 to 2015, from 33 to 16 deaths per 100 000 live births respectively. Circulatory diseases account for a high number of indirect obstetric causes of deaths in Europe [10]. In 2015, roughly 303,000 women worldwide died during pregnancy, childbirth and the postpartum period [1]. To assess underreporting of maternal deaths in Switzerland, the archive of the Institute of Forensic Medicine (IRM) was additionally searched for deaths in connection with pregnancy, childbirth and the puerperium. 2015;125(1):5–12. No further information on psychological status was available. The seven remaining women were classified as “others”. 18 Main EK, Goffman D, Scavone BM, Low LK, Bingham D, Fontaine PL, et al.