title: Trends in maternal mortality in Saudi Arabia.
abstract: OBJECTIVE
  To identify trends and factors related to maternal death, and areas that need improvement.
  
  
  METHODS
  A prospective national survey, a multistage sample of the hospitals of Saudi Arabia. The setting was a maternal mortality survey committee in Riyadh with field/area coordinators in different areas of the Kingdom. The subjects were women who died or who were dead on arrival in hospital during pregnancy or within 6 weeks of the end of pregnancy. All the data were coded and analyzed. EPINFO software was used to calculate the maternal mortality ratio (MMR) and the relative risk for the necessary variables.
  
  
  RESULTS
  The MMR was 18 per 100,000 births (155/880 248). Mortality was higher in older multiparous women of low income and no education. Hemorrhage, both antepartum and postpartum, was the leading cause of maternal death, together with rupture of the uterus and abortive bleeding, constituting 43% of direct and 29% of total maternal deaths. Substandard care was identified in 73% of direct maternal deaths.
  
  
  CONCLUSIONS
  The MMR in Saudi Arabia compares favorably with that of developed countries and the oil-producing Gulf states. Improving the number of booked patients, especially older grand multiparas, increasing the availability of banked blood and adopting a positive approach towards life-saving surgery are likely to reduce maternal deaths.
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: A
authors.initials: A
authors.lastname: al-Meshari
authors.forename: S K
authors.initials: SK
authors.lastname: Chattopadhyay
authors.forename: B
authors.initials: B
authors.lastname: Younes
authors.forename: M
authors.initials: M
authors.lastname: Hassonah
mesh_terms: D000328:Adult; D000367:Age Factors; D002585:Cesarean Section / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008428:Maternal Mortality / Q000639:trends*; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000401:mortality*; D011295:Prenatal Care; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000401:mortality; D012529:Saudi Arabia / Q000453:epidemiology; D014592:Uterine Hemorrhage / Q000401:mortality