title: Maternal mortality and the rising cesarean rate.
abstract: OBJECTIVE
  To review maternal mortality in a large stand-alone maternity hospital in a European city and to determine whether the increased cesarean rate was associated with an increase in maternal deaths.
  
  
  METHODS
  The details of maternal deaths at Coombe Women and Infants University Hospital, Dublin, Ireland, as published in the hospital's Annual Clinical Reports for 1995-2009, were reviewed. Maternal mortality ratio was defined as the number of maternal deaths per 100,000 live births.
  
  
  RESULTS
  Over 15 years, 112,326 women delivered 114 170 infants weighing at least 500 g. The cesarean rate increased from 14.1% in 1995 to 26.5% in 2009 (20.0% overall). The maternal mortality ratio was low at 2.7 per 100 000 live births. There were 2 maternal deaths following cesarean, neither of which was attributable to the operation.
  
  
  CONCLUSIONS
  In Ireland, a large stand-alone maternity hospital can achieve a low maternal mortality ratio, according to international standards, despite an increase in cesarean rate over the past 2 decades. There was no evidence that the increased cesarean rate had an adverse impact on maternal mortality ratio.
authors: UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland. vicky.odwyer@ucd.ie
authors: Vicky
authors: V
authors: O'Dwyer
authors: Jennifer L
authors: JL
authors: Hogan
authors: Nadine
authors: N
authors: Farah
authors: Mairead M
authors: MM
authors: Kennelly
authors: Christopher
authors: C
authors: Fitzpatrick
authors: Michael J
authors: MJ
authors: Turner
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000639:trends*; D005260:Female; D006771:Hospitals, Maternity / Q000706:statistics & numerical data*; D006801:Humans; D007494:Ireland; D008428:Maternal Mortality / Q000639:trends*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome