News: Thromboembolism prophylaxis urged for cesarean deliveries

The maternal death rate in the United States could be systematically reduced if all women undergoing caesarean delivery received thromboembolism prophylaxis, according to research published in the July issue of the American Journal of Obstetrics and Gynecology.

Steven L. Clark, MD, of the Hospital Corporation of America in Nashville, TN, and colleagues reviewed 2000–2006 data on nearly 1.5 million pregnancies, including 95 that resulted in maternal death.

The researchers identified complications of preeclampsia, pulmonary thromboembolism, amniotic fluid embolism, obstetric hemorrhage, and cardiac disease as the leading causes of maternal death, and concluded that only 28% of deaths were preventable because they resulted from errors committed by health-care and non-health-care personnel. They also found that the rate of maternal death causally related to the mode of delivery was higher for cesarean than for vaginal delivery (2.2 vs. 0.2 per 100,000 deliveries).

Clark SL, Belfort MA, Dildy GA, et al. Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. Am J Obstet Gynecol. 2008;199:36.e1-36.e5