title: Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom.
abstract: In the triennium 2006-2008, 261 women in the UK died directly or indirectly related to pregnancy. The overall maternal mortality rate was 11.39 per 100,000 maternities. Direct deaths decreased from 6.24 per 100,000 maternities in 2003-2005 to 4.67 per 100,000 maternities in 2006–2008 (p = 0.02). This decline is predominantly due to the reduction in deaths from thromboembolism and, to a lesser extent, haemorrhage. For the first time there has been a reduction in the inequalities gap, with a significant decrease in maternal mortality rates among those living in the most deprived areas and those in the lowest socio-economic group. Despite a decline in the overall UK maternal mortality rate, there has been an increase in deaths related to genital tract sepsis, particularly from community acquired Group A streptococcal disease. The mortality rate related to sepsis increased from 0.85 deaths per 100,000 maternities in 2003-2005 to 1.13 deaths in 2006-2008, and sepsis is now the most common cause of Direct maternal death. Cardiac disease is the most common cause of Indirect death; the Indirect maternal mortality rate has not changed significantly since 2003-2005. This Confidential Enquiry identified substandard care in 70% of Direct deaths and 55% of Indirect deaths. Many of the identified avoidable factors remain the same as those identified in previous Enquiries. Recommendations for improving care have been developed and are highlighted in this report. Implementing the Top ten recommendations should be prioritised in order to ensure the overall UK maternal mortality rate continues to decline.
authors.forename: Roch
authors.initials: R
authors.lastname: Cantwell
authors.forename: Thomas
authors.initials: T
authors.lastname: Clutton-Brock
authors.forename: Griselda
authors.initials: G
authors.lastname: Cooper
authors.forename: Andrew
authors.initials: A
authors.lastname: Dawson
authors.forename: James
authors.initials: J
authors.lastname: Drife
authors.forename: Debbie
authors.initials: D
authors.lastname: Garrod
authors.forename: Ann
authors.initials: A
authors.lastname: Harper
authors.forename: Diana
authors.initials: D
authors.lastname: Hulbert
authors.forename: Sebastian
authors.initials: S
authors.lastname: Lucas
authors.forename: John
authors.initials: J
authors.lastname: McClure
authors.forename: Harry
authors.initials: H
authors.lastname: Millward-Sadler
authors.forename: James
authors.initials: J
authors.lastname: Neilson
authors.forename: Catherine
authors.initials: C
authors.lastname: Nelson-Piercy
authors.forename: Jane
authors.initials: J
authors.lastname: Norman
authors.forename: Colm
authors.initials: C
authors.lastname: O'Herlihy
authors.forename: Margaret
authors.initials: M
authors.lastname: Oates
authors.forename: Judy
authors.initials: J
authors.lastname: Shakespeare
authors.forename: Michael
authors.initials: M
authors.lastname: de Swiet
authors.forename: Catherine
authors.initials: C
authors.lastname: Williamson
authors.forename: Valerie
authors.initials: V
authors.lastname: Beale
authors.forename: Marian
authors.initials: M
authors.lastname: Knight
authors.forename: Christopher
authors.initials: C
authors.lastname: Lennox
authors.forename: Alison
authors.initials: A
authors.lastname: Miller
authors.forename: Dharmishta
authors.initials: D
authors.lastname: Parmar
authors.forename: Jane
authors.initials: J
authors.lastname: Rogers
authors.forename: Anna
authors.initials: A
authors.lastname: Springett
mesh_terms: D003376:Counseling; D005260:Female; D006304:Health Status; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D008428:Maternal Mortality; D010348:Patient Care Team; D017410:Practice Guidelines as Topic; D016742:Preconception Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality* / Q000628:therapy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000592:standards; D011787:Quality of Health Care; D012017:Referral and Consultation; D006113:United Kingdom / Q000453:epidemiology