One in 263 pregnant women has complication
Savita Halappanavar died at University Hospital Galway last October from septicaemia after being admitted to the hospital 17 weeks into her pregnancy.
However, the first Irish national audit on maternal complications in pregnancy showed, in 2011, there was a total of four cases of septicaemia.
Obstetrics expert and director of the National Perinatal Epidemiology Centre (NPEC) in Cork, Professor Richard Greene, said all of the women who contracted septicaemia in 2011 survived.
“The numbers are thankfully small. If you take it that there were just four in 2011, that’s less than one in 10,000,” he said.
A NPEC audit found, overall, one in 263 pregnant women will develop a severe maternal medical complication during pregnancy.
However, the incident of severe maternal morbidity was disproportionately higher among ethnic minorities.
Previous research has found that ethnic minorities are at an increased risk of maternal death.
The audit found two- thirds of women who experienced maternal obstetric haemorrhaging were delivered by caesarean section while one-fifth had a spontaneous vaginal delivery.
Most units reported the quality of care in cases of major obstetric haemorrhage was appropriate with the wait time for a theatre at around 30 minutes for all but one case where a time delay was reported.
Prof Greene said patients should be reassured by the findings and especially by the commitment of the health service to reviewing outcomes to enhance the quality of care and patient safety.
He said the national morbidity rate of 3.8 per 1,000 maternity cases compared favourably with a recent audit in Scotland.
The NPEC’s audit was based on anonymous data on severe maternal morbidity collected from 19 of the 20 maternity units in Ireland.
There were seven perinatal (foetus or newborn) deaths, a rate of 32.6 per deaths per 1,000 infants born to women with severe morbidity.
The finding was substantially higher than then national rate, estimated recently at 6.6 per 1,000 births.
Prof Greene said the difference was due to the fact that the women in the audit had severe maternal medical complications that resulted in a number of early deliveries.
The rate of pregnancy related hysterectomy, at 0.3 per 1,000 and translated from 23 cases in Ireland in 2011, was similar to findings in previous international studies.
The audit found there was no clustering of cases identified in any one hospital.
Prof Greene said the audit gave a baseline of the significant conditions that can affect mothers in pregnancy.
“We hoped to have an annual report so that in a few years time we will be able to look back at trends. The audit is actually showing us in a good light and it really does show the commitment of the services, not only to provide the care, but to look at the kind of care being provided.”
