Cardiovascular Disease Contributing to Maternal Mortality in Victoria*

Summary A total of 392 maternal deaths were registered in the State of Victoria during the 14‐year period, 1953 to 1967. One hundred and four of these deaths (26.5%) were primarily due to cardiovascular disease of three main types, viz., pulmonary thromboembolism (44%), heart disease (33%) and vascular accidents (23%). Increasing age appeared to be an important aetiological factor in maternal deaths due to pulmonary embolism and vascular accidents, but did not appear to be significant as far as heart disease was concerned. High parity was a feature in the patients dying of vascular accidents but was not evident in the other two categories. By far the most impressive finding in this study was the high incidence of deaths from cardiovascular disease in the puer‐perium. The majority of deaths in each of the 3 main cardiovascular groups occurred after parturition. Post mortem examinations were performed in 54% of patients in whom a diagnosis of pulmonary thromboembolism was made, but were performed more often in patients with a diagnosis of cardiac disease or vascular accidents, i.e., in 74% and 71%, respectively. The incidence of operative delivery was high in all groups. In most cases in which avoidable factors were thought to have been present, the doctor was deemed responsible. Possible aetiolpgical factors pertaining to each group of cardiovascular diseases in relation to pregnancy have been discussed and as a result of this survey attention has been drawn to the need for further research in certain areas.