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Int J Gynaecol Obstet. 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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  • 1Heartlands Hospital, Birmingham, Birmingham, UK.



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


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


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.


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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