The 2016 Hughes Lecture : What’s new in maternal morbidity and mortality?

•Worldwide in 2014, there were about 289 000 maternal deaths.•More women with complex co-existing diseases are getting pregnant.•Increasing co-existing disease is increasing indirect maternal mortality.•The rate of maternal cardiac arrest in the USA is about one in 12 000 deliveries.•About 60% of women who experience cardiac arrest survive to hospital discharge.

Each year, the Board of Directors of the Society for Obstetric Anesthesia and Perinatology selects an individual to review a given year’s published obstetric anesthesiology literature. This individual then produces a syllabus of the year’s most influential publications, delivers the Ostheimer Lecture at the Society’s annual meeting, the Hughes Lecture at the following year’s Sol Shnider meeting, and writes corresponding review articles. This 2016 Hughes Lecture review article focuses specifically on the 2014 publications that relate to maternal morbidity and mortality. It begins by discussing the 2014 research that was published on severe maternal morbidity and maternal mortality in developed countries. This is followed by a discussion of specific coexisting diseases and specific causes of severe maternal mortality. The review ends with a discussion of worldwide maternal mortality and the 2014 publications that examined the successes and the shortfalls in the work to make childbirth safe for women throughout the entire world.