Maternal mortality due to arterial hypertension in São Paulo City (1995-1999).
OBJECTIVE
To describe the case profile of maternal death resulting from hypertensive disorders in pregnancy and to propose measures for its reduction.


METHODS
The Committee on Maternal Mortality of São Paulo City has identified 609 cases of obstetric maternal death between 1995 and 1999 with an underreporting rate of 52.2% and a maternal mortality rate of 56.7/100,000 live births. Arterial hypertension was the main cause of maternal death, corresponding to 142 (23.3%) cases.


RESULTS
Ninety-five (66.9%) of the deaths occurred during the puerperal period and 34 (23.9%) occurred during pregnancy. The time of death was not reported in 13 (9.2%) cases. Seizures were observed in 41 cases and magnesium sulfate was used in four of them. The causes of death were ruled to be cerebrovascular accident (44.4%), acute pulmonary edema (24.6%), and coagulopathies (14.1%). Cesarean section was performed in 85 (59.9%) cases and vaginal delivery in 15 (16.0%).


CONCLUSIONS
Complications of arterial hypertension are responsible for the high rates of pregnancy-related maternal death in São Paulo City. Quality prenatal care and appropriate monitoring of the hypertensive pregnant patient during and after delivery are important measures for better control of this condition and are essential to reduce disorders in pregnancy.
Vega
Carlos Eduardo Pereira
CE
Department of Obstetrics and Gynecology, University Medical School, São Paulo, SP, Brasil. carlosvega@terra.com.br
Kahhale
Soubhi
S
Zugaib
Marcelo
M
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001938:Brazil / Q000453:epidemiology; D002648:Child; D004461:Eclampsia / Q000188:drug therapy / Q000401:mortality; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000401:mortality*; D008428:Maternal Mortality; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000188:drug therapy / Q000401:mortality; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000401:mortality* / Q000517:prevention & control; D011264:Pregnancy Trimesters; D011295:Prenatal Care / Q000592:standards / Q000706:statistics & numerical data; D055815:Young Adult