Report on confidential enquiries into maternal deaths in England and Wales, 1964-1966 / by Humphrey Arthure [and others].

Date:
1969
Catalogue details

Licence: Open Government Licence

Credit: Report on confidential enquiries into maternal deaths in England and Wales, 1964-1966 / by Humphrey Arthure [and others]. Source: Wellcome Collection.

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    previous reports, but have been excluded from the clinical discussion and tables in this chapter because none of the assessors considered them pregnancy toxaemias in the accepted sense of the term. Five deaths coded to 652 (abortion with toxaemia) are counted in the abortion tables for purposes of comparison with previous reports, and in the discussion and tables in this chapter because clinically the women suffered from toxaemia but pregnancy terminated before the twenty-eighth week. The clinical discussion and tables are therefore based on the following sixty-eight deaths: Cause of Death Number No. 642-0 Hypertensive disease arising during pregnancy ... 1 642:1 Renal disease arising during pregnancy os ] 642:2 .| Pre-eclampsia of pregnancy ae - Lae 22 642-3 ~Eclampsia of pregnancy ... of AG ah 37 685 Puerperal eclampsia fees Z 652 Abortion with toxaemia without mention of sepsis 652-0 Spontaneous or unspecified (including one with eclampsia) .. ane Se ae 3 652°-1 Induced for medical reasons: ... oe a 2 Total oe 68 One case, not coded to toxaemia nor included in the tables in this section, is worthy of special mention because the patient developed hypertension and proteinuria at the thirty-sixth week of pregnancy. The signs of toxaemia rapidly worsened and a Caesarean section was performed; death occurred fifteen days later from pulmonary embolism. The post-mortem revealed an adherent thrombus blocking a main vein of the right kidney; it had presumably been present during the pregnancy giving the signs of toxaemia and by extending during the puerperium had caused the fatal pulmonary embolism. The geographical distribution of deaths from toxaemia in the Regional Hospital Board areas is shown in map I, and the population of the hospital regions is shown in map 2. Avoidable factors were considered to be piesent in thirty-eight of the sixty- eight deaths from toxaemia; this is 56 per cent and is consistent with the pro- portion of deaths with an avoidable factor in previous reports, these being 49 per cent in 1961-63, 56 in 1958-60, 55 in 1955-57 and 52 in 1952-54. Duration of pregnancy Among the sixty-eight women who died, ten died undelivered, two of whom suffered from pre-eclampsia, seven had eclamptic fits, and the other died from acute nephritis arising during pregnancy. The duration of pregnancy in the ten women who died undelivered was as follows: es