The postpartum period: the key to maternal mortality.
OBJECTIVE
To assess postpartum care at an international level, we reviewed published literature on postpartum maternal deaths.


METHODS
Meta-analysis was used to summarize the literature reviewed. Postpartum deaths in developing countries were compared with those in the United States.


RESULTS
In both developing countries and the United States, > 60% of maternal deaths occurred in the postpartum period; 45% of postpartum deaths occurred within 1 day of delivery, > 65% within 1 week, > 80% within 2 weeks. In developing countries, 80% of postpartum deaths caused by obstetric factors occurred within 1 week.


CONCLUSIONS
The first 24 h postpartum and the first postpartum week is the high risk of postpartum deaths, and the risk remains significant until the second week after delivery. In developing countries, hemorrhage, pregnancy-induced hypertension complications, and obstetric infection are commonest causes of postpartum deaths. We suggest primary prevention, early detection, and secondary prevention of postpartum deaths.
Li
X F
XF
School of Public Health, University of North Carolina, Chapel Hill, USA.
Fortney
J A
JA
Kotelchuck
M
M
Glover
L H
LH
D003906:Developing Countries; D005260:Female; D006801:Humans; D008428:Maternal Mortality; D015201:Meta-Analysis as Topic; D049590:Postpartum Period; D011247:Pregnancy; D011322:Primary Prevention; D012307:Risk Factors; D014481:United States