Maternal mortality from cardiac disease in Turkey: a population-based study

OBJECTIVE: Population-based studies on maternal deaths in Turkey are rare. The aim of the present study was to analyze the cardiac causes of all maternal deaths in Turkey between 2007 and 2009. MATERIALS AND METHODS: In this retrospective study, case files of all pregnancy-associated deaths recorded in Turkey between 2007 and 2009 were reviewed. Records for all pregnancy-associated deaths were reviewed by five authors to identify 129 cases in which a cardiac disease seemed to be the reason. For each of the 129 cases, maternal age, gravidity, parity, antenatal care attendance, district of residence, year of death, mode of delivery, perinatal outcome, and clinical history preceding death were recorded. RESULTS: During the study period, 779 maternal deaths were identified. Our estimate of the maternal mortality ratio (MMR) in 3-year period was 19.7 per 100,000 live births. The report lists 779 deaths, 411 direct and 285 indirect. Indirect obstetric causes of maternal death were primarily cardiac disorders and cerebrovascular diseases. Maternal mortality due to cardiac disease was 15.5% in 2007 and 18.4% in 2008. Valvular heart disease was the leading cause of maternal death from cardiac reasons (25.6%). Maternal mortality due to cardiac disease increased with age. CONCLUSION: The main cause of indirect maternal death has been cardiac disease in 3-year period.