Maternal mortality due to cardiac disease in Sri Lanka.
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.
Haththotuwa
Hasanthi R
HR
Heartlands Hospital, Birmingham, Birmingham, UK.
Attygalle
Deepika
D
Jayatilleka
Anoma C
AC
Karunaratna
Vineetha
V
Thorne
Sara A
SA
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