title: Current status of pregnancy-related maternal mortality in Japan: a report from the Maternal Death Exploratory Committee in Japan.
abstract: OBJECTIVE
  To clarify the problems related to maternal deaths in Japan, including the diseases themselves, causes, treatments and the hospital or regional systems.
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  Maternal death registration system established by the Japan Association of Obstetricians and Gynecologists (JAOG).
  
  
  METHODS
  Women who died during pregnancy or within a year after delivery, from 2010 to 2014, throughout Japan (N=213).
  
  
  METHODS
  The preventability and problems in each maternal death.
  
  
  RESULTS
  Maternal deaths were frequently caused by obstetric haemorrhage (23%), brain disease (16%), amniotic fluid embolism (12%), cardiovascular disease (8%) and pulmonary disease (8%). The Committee considered that it was impossible to prevent death in 51% of the cases, whereas they considered prevention in 26%, 15% and 7% of the cases to be slightly, moderately and highly possible, respectively. It was difficult to prevent maternal deaths due to amniotic fluid embolism and brain disease. In contrast, half of the deaths due to obstetric haemorrhage were considered preventable, because the peak duration between the initial symptoms and initial cardiopulmonary arrest was 1-3 h.
  
  
  CONCLUSIONS
  A range of measures, including individual education and the construction of good relationships among regional hospitals, should be established in the near future, to improve primary care for patients with maternal haemorrhage and to save the lives of mothers in Japan.
authors.affiliation: St. Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Hasegawa
authors.affiliation: Showa University School of Medicine, Tokyo, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Sekizawa
authors.affiliation: Mie University School of Medicine, Mie, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Sakakibara Heart Institute, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Katsuragi
authors.affiliation: Mie University School of Medicine, Mie, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Osato
authors.affiliation: Seirei Hamamatsu General Hospital, Shizuoka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Murakoshi
authors.affiliation: Toho University, Tokyo, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Nakata
authors.affiliation: Showa University School of Medicine, Tokyo, Japan.
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Yoshimatsu
authors.affiliation: Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan.
authors.forename: Tomohito
authors.initials: T
authors.lastname: Sadahiro
authors.affiliation: Hamamatsu University School of Medicine, Shizuoka, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Kanayama
authors.affiliation: Ishiwata Obstetrics and Gynecology Hospital, Ibaraki, Japan.
authors.forename: Isamu
authors.initials: I
authors.lastname: Ishiwata
authors.affiliation: Seijyo Kinoshita Hospital, Tokyo, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kinoshita
authors.affiliation: Mie University School of Medicine, Mie, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D001927:Brain Diseases / Q000453:epidemiology; D002423:Cause of Death; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004619:Embolism, Amniotic Fluid / Q000453:epidemiology; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D007564:Japan; D063130:Maternal Death / Q000209:etiology* / Q000517:prevention & control; D008428:Maternal Mortality / Q000639:trends*; D011181:Postnatal Care / Q000592:standards; D011247:Pregnancy; D011248:Pregnancy Complications; D011295:Prenatal Care / Q000592:standards; D055815:Young Adult
keywords: DIC; amniotic fluid embolism; maternal death; maternal mortality; postpartum hemorrhage