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J Turk Ger Gynecol Assoc. 2018 Jun 8. doi: 10.4274/jtgga.2018.0082. [Epub ahead of print]

The value of autopsy to determine the cause of maternal deaths in Turkey.

Author information

1
General Directorate of Mother and Child Health and Family Planning, Ministry of Health of Turkey, Ankara, Turkey.

Abstract

OBJECTIVE:

To analyse the value of autopsy reports for determining the cause of maternal deaths in Turkey.

MATERIAL AND METHODS:

In this descriptive retrospective study, case files of 992 maternal deaths except for accidental causes occurred in Turkey between 2012 and 2016 were reviewed. An autopsy examination was performed in 177 (17.8%) out of the cohort. When the files were reviewed maternal descriptive data and the cause of maternal mortality according to the autopsy reports were recorded.

RESULTS:

The mean age at death was 31.5 ±6.6 years. Although in 44 (24.9%) out of 177 cases no exact cause of maternal death was identified after autopsy, in 133 (75.1%) cases the exact cause of death could be determined and while 34.5% (n=61) of them were due to direct causes, 40.7% (n=72) were due to indirect causes. The leading causes of the direct maternal deaths were obstetric hemorrhage (13.0%) and obstetric (pulmonary and amniotic fluid) embolism (12.4%). The main cause among the indirect causes was ruptured aortic aneurysm and/or dissection of aorta (8.5%). Among the subjects had not any clinical diagnosis based on the clinical course before the death happened (n=96), in nine-teen (19.8%) cases the exact cause of death couldn't determine at autopsy. Nonetheless, in 80.3% (n=77) cases without any clinical diagnosis the exact or possible cause of death were identified at autopsy. Among the cases who had any ante mortem diagnosis based on the clinical course (n= 81) the final diagnosis at autopsy was compatible with the clinical diagnosis in 48 (59.3%) subjects.

CONCLUSION:

Maternal autopsy examination provides an exact cause of death in most cases and is still a valuable tool for understanding the cause of maternal mortalities.

KEYWORDS:

Maternal mortality autopsy.

PMID:
29880464
DOI:
10.4274/jtgga.2018.0082
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