title: Maternal deaths in Finland: focus on placental abruption.
abstract: OBJECTIVE. To study placental abruption-associated maternal deaths out of all maternal deaths in Finland. DESIGN. Register-based study. SETTING. The Finnish Medical Birth Register (MBR), the Hospital Discharge Register (HDR), and the Cause-of-Death Register data during 1972-2005. METHODS. The maternal deaths were identified by linking data from the MBR, the HDR, and the Cause-of-Death Register. The clinical data were collected from the case records and death certificates. MAIN OUTCOME MEASURES. Cause-specific maternal death with special reference to placental abruption. RESULTS. During the study period, a total of 2,104,436 live births and 117 direct maternal deaths (caused by a disease or its management unique to the pregnancy) occurred in Finland. The direct maternal mortality ratio (MMR) was 5.6 per 100,000 live births. The two leading causes were thromboembolism (24.0%) and hemorrhage (22.3%) representing almost half of all maternal deaths. Altogether 7,735 placental abruptions were identified with three maternal deaths giving a case fatality rate of 0.4 per 1,000 cases. The MMR (38.8 per 100,000) was nearly seven times higher than the overall MMR (5.7 per 100,000) (p=0.010). CONCLUSION. The direct MMR in Finland is at the level generally seen in Western Europe. The main causes to maternal death are thromboembolism and obstetric hemorrhage. Deaths to placental abruption are rare, but still seven times higher than the overall MMR.
authors.affiliation: Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Minna
authors.initials: M
authors.lastname: Tikkanen
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.forename: Marjo
authors.initials: M
authors.lastname: Metsäranta
authors.forename: Tiina
authors.initials: T
authors.lastname: Luukkaala
authors.forename: Vilho
authors.initials: V
authors.lastname: Hiilesmaa
authors.forename: Sture
authors.initials: S
authors.lastname: Andersson
authors.forename: Olavi
authors.initials: O
authors.lastname: Ylikorkala
authors.forename: Jorma
authors.initials: J
authors.lastname: Paavonen
authors.forename: Mika
authors.initials: M
authors.lastname: Nuutila
mesh_terms: D000037:Abruptio Placentae / Q000401:mortality*; D000328:Adult; D002423:Cause of Death; D004211:Disseminated Intravascular Coagulation / Q000401:mortality; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008428:Maternal Mortality; D011247:Pregnancy; D012042:Registries; D013923:Thromboembolism / Q000401:mortality; D014592:Uterine Hemorrhage / Q000401:mortality