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10/08/2011
'Urgent Action' Call On Maternal Deaths
The number of obstetric physicians in the UK needs to be increased and training in this area expanded in order to tackle the "worrying trend in the causes of maternal mortality in the UK", experts have warned on bmj.com today.
Catherine Nelson-Piercy, Professor of Obstetric Medicine at King's College London and colleagues, say that while there has been a dramatic reduction in the maternal death rate in the UK since the 1950s, the number of maternal deaths due to "indirect" causes has significantly increased in the last twenty years.
The main causes of "indirect" deaths in pregnancy are the result of cardiac or neurological disease, they say.
Worringly, the authors argue that "most of these deaths are associated with substandard care, and in one third of cases this is classified as major substandard care, where different care might have prevented death of the mother. These failings require urgent attention."
Obstetricians and midwives cannot reduce maternal deaths on their own, maintain the authors. They say more training is needed for doctors so that they are alerted to the possible underlying problems when pregnant women present with, for example breathlessness, headache and abdominal pain.
It is also essential, say the authors, that the number of obstetric physicians is increased and that this sub-speciality is formally recognised. Obstetric physicians specialise in looking after women with both pre-existing and new medical problems during pregnancy and they often provide specialised pre-pregnancy counselling.
Other surgical specialties, such as neurosurgery, urology and cardiac surgery have medical counterparts, says Professor Nelson-Piercy, and "many other countries, including Canada, USA, Australia and New Zealand, recognise the importance of obstetric medicine and have well developed training programmes."
With increasing numbers of older women and women with complex medical conditions before becoming pregnant, the need for informed pre-pregnancy counselling and continued expert care is more important than ever, they conclude.
(KMcA/BMcC)
Catherine Nelson-Piercy, Professor of Obstetric Medicine at King's College London and colleagues, say that while there has been a dramatic reduction in the maternal death rate in the UK since the 1950s, the number of maternal deaths due to "indirect" causes has significantly increased in the last twenty years.
The main causes of "indirect" deaths in pregnancy are the result of cardiac or neurological disease, they say.
Worringly, the authors argue that "most of these deaths are associated with substandard care, and in one third of cases this is classified as major substandard care, where different care might have prevented death of the mother. These failings require urgent attention."
Obstetricians and midwives cannot reduce maternal deaths on their own, maintain the authors. They say more training is needed for doctors so that they are alerted to the possible underlying problems when pregnant women present with, for example breathlessness, headache and abdominal pain.
It is also essential, say the authors, that the number of obstetric physicians is increased and that this sub-speciality is formally recognised. Obstetric physicians specialise in looking after women with both pre-existing and new medical problems during pregnancy and they often provide specialised pre-pregnancy counselling.
Other surgical specialties, such as neurosurgery, urology and cardiac surgery have medical counterparts, says Professor Nelson-Piercy, and "many other countries, including Canada, USA, Australia and New Zealand, recognise the importance of obstetric medicine and have well developed training programmes."
With increasing numbers of older women and women with complex medical conditions before becoming pregnant, the need for informed pre-pregnancy counselling and continued expert care is more important than ever, they conclude.
(KMcA/BMcC)
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