Meili G, Huch R, Huch A, Zimmermann R. Mütterliche Mortalität in der Schweiz 1985–1994 [Maternal mortality in Switzerland 1985-1994]. 2010;140(1-2):25–30. Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland. Swiss Medical Weekly EMH Swiss Medical Publishers Ltd. Farnsburgerstrasse 8 CH-4132 Muttenz Tel. Infant health: low birthweight. Compared with the previous study periods, a reduction could be observed (1985–1994: 1.23/100,000 live births vs 2005–2014: 0.64/100,000 live births, p = n.s.) doi:. ; National Parternship for Maternal Safety; Council for Patient Safety in Women’s Health Care. In the current study, two cases were found in which a direct link to caesarean section seemed plausible and thus were used for the calculation of the lethality of a caesarean section. 2019;134(4):881–2. As yet there are no detailed numbers of the actual causes of death for Switzerland. Seven cases had to be excluded because only ICD-10 codes and no further detailed information on the circumstances of these deaths were available (table 1). Lethality after caesarean section was 0.008‰ (2/231,385). In the current study, the most common cause of direct obstetric death, if suicide were counted as indirect cause, was haemorrhage (1.14/100,000 live births). Available from: Bundesamt für Statistik. Obstet Gynecol. 2018;229:148–52. The high number of maternal deaths in some areas of the world reflects inequities in access to health services, and highlights the gap between rich and poor. In 2009–2011 and 2012–14, the ratio decreased from 0.42 to 0.11/100,000 live births. Cardiovasc Diagn Ther. We received 117 cases from the FSO, and one additional case was found in the archives of the IRM. 7 Bundesamt für Statistik. Communicable diseases. 11 Moussa HN, Rajapreyar I. ACOG Practice Bulletin No. Women with permanent residence in Switzerland, those who died in Switzerland or abroad, and those who died in Switzerland but were not residing permanently in Switzerland were included in the study. All suggestions for corrections of any errors about Maternal mortality rate should be addressed to the CIA. When comparing the frequency of embolism and haemorrhage after caesarean section versus vaginal delivery in all available cases, we did not find a difference (table 6). doi:. In the two other indirect cases, both women suffered from known pre-existing vascular malformations and thus had received anticoagulant therapy. In the current study, 13 women committed suicide. One woman suffered from severe vaginal bleeding and died of a myocardial infarction. In conclusion, a reduction in direct maternal mortality in Switzerland compared with the previous study periods has been accomplished. A New Method for Deriving Global Estimates of Maternal Mortality Wilmot JR et al., Statistics, Politics and Policy, 2012, 3(2): 1-38; Related information. If the suicide cases are included in the direct mortality, the ratio would be 5.0/100,000 live births (table 4). 2016;387(10017):462–74. Saving Lives, Improving Mothers’ Care: Surveillance of Maternal Deaths in the UK 2012–14 and Lessons Learned to Inform Maternity Care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–14. Curr Opin Obstet Gynecol. 2015;125(1):5–12. Deep venous thrombosis in pregnancy: incidence, pathogenesis and endovascular management. Neonatal mortality rate is the number of neonates dying before reaching 28 days of age, per 1,000 live births in a given year. The only information given for these cases was the ICD-code R99 (Other ill-defined and unspecified causes of mortality) and, in 13 cases, the time that had passed since childbirth (0–331 days). Lebendgeburten nach Alter der Mutter und Kanton 2015. http://dx.doi.org/10.1016/0002-9378(95)91474-9 PubMed, 21 Devis P, Knuttinen MG. The trend of reducing direct maternal mortality as well as lethality after caesarean section continues. In order to reduce underreporting, the WHO introduced in 2012 the International Classification of Disease for Maternal Mortality (ICD-MM), in which all suicides during pregnancy and up to a year after the birth are to be classified as direct obstetric deaths . Article in German. Nonetheless, compared with the study period of 1985–1994 (0.98/100,000 live births), maternal mortality has actually risen (fig. EUP = extrauterine pregnancy; HELLP = haemolysis, elevated liver enzymes, low platelet count. The ethics committees of each participating canton approved this national cohort study (KEK Nr. WHO. Reported risk factors for amniotic fluid embolisms include operative delivery (vaginal or caesarean), placenta praevia, placenta accreta and abruption, since in these situations an exchange of fluids between the maternal and fetal compartments is more likely . This included one direct, one indirect, all 11 postpartum suicides and 29 non-pregnancy-related deaths. Two authors (RZ and KQL) were involved in the process of classification in the previous study periods. The seven cases excluded because lack of information made it impossible to categorise them. Solely relying on the visual assessment of blood loss is insufficient as it is underestimated routinely by 30–50% . Additional information can be found here. Morbidity. 2020;150:w20345. http://dx.doi.org/10.1007/s10995-013-1403-x PubMed, 24 Heslehurst N, Brown H, Pemu A, Coleman H, Rankin J. Perinatal health outcomes and care among asylum seekers and refugees: a systematic review of systematic reviews. No claims are made regarding theaccuracy of Maternal mortality rate information contained here. However, the direct maternal mortality ratio was also calculated with the suicides included to evaluate the new trend of classifying them as direct cases (table 4). Poor mental health during pregnancy or following delivery can have severe implications for maternal mortality. 2019;134(4):881–2. As 787,025 live births were recorded between 2005 and 2014 in Switzerland, the direct MMR was 3.30/100,000 live births (26 cases). National Partnership for Maternal Safety: consensus bundle on obstetric hemorrhage. Studies have provided evidence that socially disadvantaged and migrated women have worse perinatal outcomes and are at a higher risk for maternal mortality [23, 24]. Haemorrhage was classified as a direct obstetric case, except for one indirect case. In the current study, as many as 30.8% of all indirect maternal deaths were a result of a cardiac pathology. The mean maternal age at death was 33.2 years (range 19–51). 16 Mangla K, Hoffman MC, Trumpff C, O’Grady S, Monk C. Maternal self-harm deaths: an unrecognized and preventable outcome. To improve clinical care, maternal mortality should be assessed periodically. 2016–00240). 2013;25(2):91–7. One additional case was found by searching the archive of the IRM. Indirect maternal mortality is increasing and specifically suicides need special attention. The indirect MMR was 3.68/100,000 live births. Available from: https://www.bfs.admin.ch/bfs/de/home/statistiken/bevoelkerung/geburten-todesfaelle/geburten.html. Definition: The maternal mortality ratio (MMRatio) is the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes). http://dx.doi.org/10.1097/AOG.0000000000000564 PubMed, 13 Zöllner J, Curry R, Johnson M. The contribution of heart disease to maternal mortality. As the graph below shows, over the past 17 years this indicator reached a maximum value of 13,900 in 2017 and a … The main outcome of this study was to determine the ratios and causes of maternal mortality in Switzerland from 2004–2015 and to compare the results of this study period with the previously analysed study periods, including age and origin of the women. Together with amniotic fluid embolism, preeclampsia/HELLP was found to be the second leading cause of maternal mortality in Switzerland, each accounting for almost 20% of all direct obstetric deaths (0.64/100,000 live births). Nonetheless, maternal deaths still occur during this period and are tragic. The maternal mortality rate in the west has dropped drastically in the last 100 years. More than half (62.5%) of these women were known to suffer from a pre-existing cardiac disease. UNICEF and the World Health Organization periodically evaluate these data and make adjustments to account for the well-documented problems of under-reporting and misclassification of maternal deaths and to develop estimates for countries with … Mangla K, Hoffman MC, Trumpff C, O’Grady S, Monk C. Maternal self-harm deaths: an unrecognized and preventable outcome. Public Service Open Access is also known als Diamond or Platinum OA. 212: Pregnancy and Heart Disease. 9 EURO-PERISTAT Project with SCPE and EUROCAT. The physician who had signed the death certificate, or the corresponding clinic, was asked to complete an anonymous questionnaire on further information on the circumstances of the deaths. The median age of the women who committed suicide was 36.7 years. Regional Office for the Western P. Sustainable development goals (SDGs): Goal 3. Due to improved monitoring strategies, an increase in maternal mortality was expected. An in-depth questionnaire sent to the clinic that filled out the death certificate immediately after the registration of such deaths could improve the quality of data. 2). https://doi.org/10.4414/smw.2020.20345 15 World Health Organisation. Matern Child Health J. The most common direct obstetric cause of death in Europe was haemorrhage (15% of maternal deaths, 0.87/100,000 live births), followed by preeclampsia/HELLP (12%, 0.72/100,000 live births) between 2006 and 2010 . Bundesamt für Statistik. In one case, information was not provided as it was subject to an ongoing legal case. This works out at around 1.26 million maternal deaths [140 million / [900 / 100,000] = 1.26 million]. Additionally, since 2007, birth data can be linked with the date of death of the mother, thus allowing identification of women who had given birth in the year before death. In this group, 13 women committed suicide and 8 women died of complications of pre-existing cardiac pathologies. The maternal mortality rate in the west has dropped drastically in the last 100 years. Perceived health status by age and gender. Periodic analysis of maternal deaths is not only an important tool for quality assurance in obstetrics, but is also necessary to improve clinical care. This could be attributed to the fact that the inclusion criteria and recording of maternal mortality cases have improved. We also included cases where death occurred within 365 days after delivery. NOTE: The information regarding Maternal mortality rate on this page is re-published from the CIA World Factbook 2017. Swiss Med Wkly. doi:. Maternal age, nationality and time of death in relation to delivery were analysed as demographic and temporal factors. Between 2005 and 2014, 29.4% of all 787,025 live births in Switzerland occurred by caesarean section, which results in 231,385 live births by caesarean section. 2017;7(S3, Suppl 3):S309–19. +41 (0)61 467 85 55 Fax +41 (0)61 467 85 56 e-mail: Editorial office, EMH MediaSchweizerische ÄrztezeitungSwiss Medical ForumPrimary and Hospital CareCardiovascular MedicineSwiss Archives of Neurology, Psychiatry and PsychotherapySynapseSwiss Medical Informatics. In 2019, neonatal mortality rate for Switzerland was 2.8 deaths per 1,000 live births. http://dx.doi.org/10.1016/j.ejogrb.2018.08.586 PubMed. In 42 cases, the mode of delivery was not known. - Maternal mortality ratio (per 100,000 live births): 5 (#165 highest) ... - Mortality rate attributed to household and ambient air pollution (per 100,000 people): 20 (#153 highest) ... Switzerland's health-care system is one of the best in the world. As much as 99% of all maternal deaths occurred in developing countries and most of these deaths could have been prevented. Maternal mortality ratio , 2008-2012*, Reported – Maternal mortality ratio , 2010, Adjusted. Maternal mortality rate: 5 deaths/100,000 live births (2017 est.) 6 Bundesamt für Statistik. In the current study, 79 women gave birth, among whom 24 (30.4%) had caesarean sections, but the delivery mode was unknown in 42 cases. So, they were either not able or not willing to give a detailed report of the incident. From 1990 to 2015, global maternal mortality fell from 385/100,000 to 216/100,000 live births, a reduction of 43.9%. Lebendgeburten nach Alter der Mutter und Kanton 2015. In all other direct cases, caesarean sections were due to pre-existing pregnancy-related diseases or conditions that were further aggravated during pregnancy: preeclampsia/HELLP (n = 3) and placental abruption (n = 2). 8. In five cases, the women died because of uterine atony. All maternal deaths that were temporally correlated with a caesarean section were included in the calculation of mortality after caesarean section, independent of the cause of death. No claims are made regarding the accuracy of Maternal mortality rate information contained here. The maternal mortality data are those reported by national authorities. Suicide was the leading cause of maternal deaths, had suicides been classified as direct obstetric cases. 2). doi:. We have provided a few examples below that you can copy and paste to your site: Your image export is now complete. 2015;126(1):155–62. The Federal Statistical Office (FSO) provided all death certificates between 2005 and 2014 with an ICD-10 code in the obstetric field (indicated with the letter O). Maternal mortality ratio, adjusted (per 100,000 live births) Maternal mortality ratio, reported (per ... Switzerland Introduction of solid, semi-solid or soft foods (6-9 months, %) ... Under-five mortality rate Deaths per 1000 live births Trends in Maternal Mortality… http://dx.doi.org/10.1016/S0140-6736(15)00838-7 PubMed. The UN estimates there were around 140 million births in 2015. In the last 30 years, a slight reduction in amniotic fluid embolism from the first to the second study period was observed (fig. doi:. Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births [poster]. : maternal mortality, Switzerland, direct mortality, indirect mortality, non-pregnancy-related mortality. For an analysis of underreporting, cases from the Institute of Forensic Medicine (IRM), Zurich, were included. Maternal mortality ratio (modeled estimate, per 100,000 live births) - Switzerland WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. Pip: there are several limitations to address in this group, 13 women committed suicide the... 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