A representative from the outlying institution should call our Department of Pathology at 51 to discuss any cases under consideration for an autopsy and to arrange appropriate transfer or records and paperwork prior to the transportation of the patient. Routine autopsies are generally performed Monday through Friday during usual working hours. Cincinnati Children’s has a tradition of highly-trained pediatric pathologists who are available to the region for comprehensive fetal and perinatal postmortem examinations. All rights reserved.The Division of Pathology at Cincinnati Children’s provides autopsy services for outlying institutions. Suicide is an important direct cause of late maternal death.Ĭause of death epidemiology maternal mortality methods public health surveillance.Ĭopyright © 2020 The Authors. The majority of maternal deaths in Canada have direct obstetric causes, whereas most late maternal deaths have indirect obstetric causes. One hundred late maternal deaths (83%) had indirect obstetric causes and <5 (<4%) had undetermined causes. Of 120 late maternal deaths, 16 (13%) had direct obstetric causes, among them, 9 deaths by suicide (56%). There were 21 (25%) maternal deaths with indirect obstetric causes, and <5 (<6%) with undetermined causes. Direct obstetric causes included 8 deaths (9%) related to complications of spontaneous or induced abortion 9 (11%), to hypertensive disorders of pregnancy 15 (18%), to obstetric hemorrhage 11 (13%), to pregnancy-related infection 16 (19%), to other obstetric complications and <5 (<6%), to complications of management. Maternal deaths (i.e., while pregnant or within 42 days after the end of pregnancy) and late maternal deaths (i.e., more than 42 days to a year after the end of pregnancy) were examined separately. A sequential narrative based on hospital admission(s) during and after pregnancy was constituted and reviewed to assign the underlying cause of death (based on the World Health Organization's framework). We used data from the Discharge Abstract Database for fiscal years 2013 to 2017 to identify women who died in Canadian hospitals (excluding Quebec) while pregnant or within 1 year of the end of pregnancy. We developed a method for identifying underlying causes of maternal death, and quantified the frequency of maternal death by cause. Maternal death surveillance in Canada relies on hospitalization data, which lacks information on the underlying cause of death. 7 Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital of British Columbia, Vancouver, BC School of Population and Public Health, University of British Columbia, Vancouver, BC.6 The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON Department Obstetrics and Gynaecology, University of Toronto, Toronto, ON.5 The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON.4 Department of Obstetrics and Gynaecology, Dalhousie University and the IWK Health Centre, Halifax, NS.3 Maternal and Infant Health Section, Public Health Agency of Canada, Ottawa, ON.Electronic address: 2 Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital of British Columbia, Vancouver, BC. 1 Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital of British Columbia, Vancouver, BC.
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