title: Maternal mortality due to cardiac disease in Sri Lanka.
abstract: OBJECTIVE
  To investigate Sri Lankan maternal deaths due to heart disease and to consider low-cost interventions to reduce these deaths.
  
  
  METHODS
  A qualitative study based on retrospective audit of all maternal deaths and late maternal deaths in Sri Lanka caused by cardiac disease in 2004.
  
  
  RESULTS
  A total of 145 maternal deaths were recorded in 2004, for a maternal mortality rate of 38 per 100,000. There were 42 indirect deaths, 25 of which were due to cardiac disease; 23 deaths had a specific cardiac cause listed. Standard care was identified in prepregnancy counseling, contraception, and prenatal community and specialist care.
  
  
  CONCLUSIONS
  Cardiac disease is a major cause of maternal mortality in Sri Lanka, second only to postpartum hemorrhage. Rheumatic mitral valve disease is responsible for more than a third of maternal deaths from cardiac disease. Substandard care was identified in all cases; strategies to improve care could allow a reduction in maternal cardiac deaths.
authors.affiliation: Heartlands Hospital, Birmingham, Birmingham, UK.
authors.forename: Hasanthi R
authors.initials: HR
authors.lastname: Haththotuwa
authors.forename: Deepika
authors.initials: D
authors.lastname: Attygalle
authors.forename: Anoma C
authors.initials: AC
authors.lastname: Jayatilleka
authors.forename: Vineetha
authors.initials: V
authors.lastname: Karunaratna
authors.forename: Sara A
authors.initials: SA
authors.lastname: Thorne
mesh_terms: D002423:Cause of Death; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000401:mortality*; D006801:Humans; D008427:Maternal Health Services; D008428:Maternal Mortality; D007744:Obstetric Labor Complications / Q000401:mortality*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000401:mortality*; D011787:Quality of Health Care; D012189:Retrospective Studies; D013188:Sri Lanka / Q000453:epidemiology