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American Journal of Public Health logoLink to American Journal of Public Health
. 1988 Jun;78(6):671–675. doi: 10.2105/ajph.78.6.671

Hemorrhage, infection, toxemia, and cardiac disease, 1954-85: causes for their declining role in maternal mortality.

B P Sachs 1, D A Brown 1, S G Driscoll 1, E Schulman 1, D Acker 1, B J Ransil 1, J F Jewett 1
PMCID: PMC1350280  PMID: 3369599

Abstract

Hemorrhage, infection, toxemia, and cardiac disease are no longer the leading causes of maternal death. We studied factors causing their decline in incidence using data collected by the Committee on Maternal Welfare of the Massachusetts Medical Society between 1954 and 1985. The dramatic decline in incidence of these conditions in the Commonwealth during the study period appears to have been due to both legislative actions and improvements in medical practice. The legislative actions included licensing of maternity services, blood banks, and legalization of abortion. Cardiac-related mortality has declined due to a reduction in the prevalence of rheumatic heart disease. Changes in clinical practice that stand out were the aggressive control of the hypertensive component of toxemia leading to a reduced incidence of intracranial hemorrhage, the prompt recourse to blood transfusion for hemorrhage, and the use of broad spectrum antibiotics.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Evans S., Frigoletto F. D., Jr, Jewett J. F. Mortality of eclampsia: a case report and the experience of the Massachusetts Maternal Mortality Study, 1954-1982. N Engl J Med. 1983 Dec 29;309(26):1644–1647. doi: 10.1056/NEJM198312293092612. [DOI] [PubMed] [Google Scholar]
  2. Jewett J. F. Multiparous uterine atony. N Engl J Med. 1972 Apr 6;286(14):778–779. doi: 10.1056/NEJM197204062861413. [DOI] [PubMed] [Google Scholar]
  3. Jewett J. F. Septic induced abortion. N Engl J Med. 1973 Oct 4;289(14):748–749. [PubMed] [Google Scholar]
  4. Jewett J. F. Two deaths from mid-trimester abortion. N Engl J Med. 1973 Jan 4;288(1):47–48. doi: 10.1056/NEJM197301042880114. [DOI] [PubMed] [Google Scholar]
  5. Kaunitz A. M., Hughes J. M., Grimes D. A., Smith J. C., Rochat R. W., Kafrissen M. E. Causes of maternal mortality in the United States. Obstet Gynecol. 1985 May;65(5):605–612. [PubMed] [Google Scholar]
  6. Sachs B. P., Brown D. A., Driscoll S. G., Schulman E., Acker D., Ransil B. J., Jewett J. F. Maternal mortality in Massachusetts. Trends and prevention. N Engl J Med. 1987 Mar 12;316(11):667–672. doi: 10.1056/NEJM198703123161105. [DOI] [PubMed] [Google Scholar]
  7. Sachs B. P., Masterson T., Jewett J. F., Guyer B. Reproductive mortality in Massachusetts in 1981. N Engl J Med. 1984 Sep 6;311(10):667–670. doi: 10.1056/NEJM198409063111011. [DOI] [PubMed] [Google Scholar]

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