[Hospital maternal mortality: causes and consistency between clinical and autopsy diagnosis at the Northeastern Medical Center of the IMSS, Mexico].
The aim was to study the causes of maternal mortality (MM) and the percent of concordance between the clinical diagnosis and the autopsy findings.


METHODS
The autopsies of maternal death (1980-1999) from the Hospital de Especialidades, Centro Médico del Noreste, IMSS in Monterrey, México, were analyzed. The cases were classified in directly obstetric maternal mortality (DOM) and indirectly obstetric maternal mortality (IOM), the causes were studied and the percent of concordance between pre- and post-mortem diagnosis was determined.


RESULTS
There were 124 deaths. Autopsy was performed in 61 (49.1%) women. In 55 cases the clinical file and the autopsy protocol were available. This was our sample for study. Sixty percent of the cases were DO. Causes of DOM were: specific hypertensive pregnancy disease (SHPD) (51.6%), sepsis (35.5%), hypovolemic shock (9.7%), anesthetic accidents (3%); causes of IOM were: sepsis (41.7%), malignancies (16.7%), hematological diseases (12.5%), cardiopathy and systemic arterial hypertension (12.5%), hepatic disorders (12.5%), and Superior Longitudinal Sinus thrombosis (4%). A 100% clinical-pathological concordance was observed in DOM cases, while only a 41.6% was found in IOM cases. In those cases of sepsis (IOM), the etiologic agents were identified only in 20% before death.


CONCLUSIONS
The early detection and treatment of SHPD and the prevention of sepsis should decrease the MM. This study showed some weakness in the Health Services that should be improved.
Calderón-Garcidueñas
Ana Laura
AL
Departamento de Anatomía Patológica, Hospital de Especialidades No. 25, Centro Médico del Noreste, IMSS, Monterrey, Nuevo León, México.
Martínez-Salazar
Griselda
G
Fernández-Díaz
Héctor
H
Cerda-Flores
Ricardo M
RM
D000328:Adult; D001344:Autopsy; D002423:Cause of Death; D005260:Female; D017052:Hospital Mortality; D006761:Hospitals; D006801:Humans; D008428:Maternal Mortality; D008800:Mexico; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*