Key result
Cardiac disease accounted for 25 of 145 maternal deaths in Sri Lanka in 2004, with rheumatic mitral valve disease responsible for over a third of these cardiac deaths.
Observational (n=145)
Cardiac disease, particularly rheumatic mitral valve disease, is a leading cause of maternal mortality in Sri Lanka, highlighting the need for improved prepregnancy and prenatal care.
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Should prompt pre-pregnancy evaluation in women with known rheumatic heart disease; observational data extends regional epidemiology but does not yet guide practice changes.
OBJECTIVE: To investigate Sri Lankan maternal deaths due to heart disease and to consider low-cost interventions to reduce these deaths. METHODS: A qualitative study based on retrospective audit of all maternal deaths and late maternal deaths in Sri Lanka caused by cardiac disease in 2004. RESULTS: A total of 145 maternal deaths were recorded in 2004, for a maternal mortality rate of 38 per 100,000. There were 42 indirect deaths, 25 of which were due to cardiac disease; 23 deaths had a specific cardiac cause listed. Standard care was identified in prepregnancy counseling, contraception, and prenatal community and specialist care. CONCLUSION: Cardiac disease is a major cause of maternal mortality in Sri Lanka, second only to postpartum hemorrhage. Rheumatic mitral valve disease is responsible for more than a third of maternal deaths from cardiac disease. Substandard care was identified in all cases; strategies to improve care could allow a reduction in maternal cardiac deaths.
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Haththotuwa et al. (2008) conducted an observational in Maternal mortality due to cardiac disease (n=145). Cardiac disease was evaluated on Maternal deaths. Cardiac disease accounted for 25 of 145 maternal deaths in Sri Lanka in 2004, with rheumatic mitral valve disease responsible for over a third of these cardiac deaths.
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