Maternal mortality due to cardiac disease in Sri Lanka

ObjectiveTo investigate Sri Lankan maternal deaths due to heart disease and to consider low-cost interventions to reduce these deaths.MethodsA qualitative study based on retrospective audit of all maternal deaths and late maternal deaths in Sri Lanka caused by cardiac disease in 2004.ResultsA total of 145 maternal deaths were recorded in 2004, for a maternal mortality rate of 38 per 100 000. There were 42 indirect deaths, 25 of which were due to cardiac disease; 23 deaths had a specific cardiac cause listed. Standard care was identified in prepregnancy counseling, contraception, and prenatal community and specialist care.ConclusionCardiac disease is a major cause of maternal mortality in Sri Lanka, second only to postpartum hemorrhage. Rheumatic mitral valve disease is responsible for more than a third of maternal deaths from cardiac disease. Substandard care was identified in all cases; strategies to improve care could allow a reduction in maternal cardiac deaths.