Table 2.
Maternal causes of death as determined by InterVA and physician review for overall deaths (N=143)
| Physician review | InterVA-4 | InterVA-5 | |||
|---|---|---|---|---|---|
| Three-category classification (ICD-MM) | |||||
| Direct maternal cause | 88 (62%) | 100 (70%) | 110 (77%) | ||
| Indirect maternal cause | 39 (27%) | 37 (26%) | 28 (20%) | ||
| Undetermined cause | 16 (11%) | 6 (4%) | 5 (3%) | ||
| Nine-category classification (ICD-MM) | |||||
| (1) Abortive outcomes | 1 (1%) | 0 | 1 (1%) | ||
| (2) Hypertensive disorders | 23 (16%) | 25 (17%) | 24 (17%) | ||
| (3) Obstetric haemorrhage | 38 (27%) | 69 (48%) | 82 (57%) | ||
| (4) Pregnancy-related infection | 6 (4%) | 2 (1%) | 0 | ||
| (5) Other obstetric complications | 16 (11%) | 4 (3%) | 3 (2%) | ||
| Venous thromboembolism | 8/16 | 0 | 0 | ||
| Uterine inversion or rupture | 2/16 | 0 | 1/3 | ||
| Suicide | 2/16 | 1/4 | 1/3 | ||
| Obstructed labour | 0 | 3/4 | 1/3 | ||
| Other* | 4/16 | 0 | 0 | ||
| (6) Unanticipated complications of clinical management | 4 (3%) | 0 | 0 | ||
| (7) Non-obstetric complications | 39 (27%) | 37 (26%) | 28 (20%) | ||
| Infectious disease | 26/39 | 28/37 | 20/28 | ||
| Respiratory | 9 | 11 | 9 | ||
| Gastrointestinal | 3 | 1 | 0 | ||
| Malaria | 5 | 4 | 1 | ||
| HIV | 2 | 8 | 7 | ||
| Tuberculosis | 2 | 3 | 1 | ||
| Other† | 5 | 1 | 2 | ||
| Cardiac disease | 10/39 | 3/37 | 4/28 | ||
| Liver disease | 2/39 | 3/37 | 2/28 | ||
| Other‡ | 1/39 | 3/37 | 2/28 | ||
| (8) Unknown or undetermined | 16 (11%) | 6 (4%) | 4 (3%) | ||
| (9) Coincidental causes | 0 | 0 | 1 (1%) | ||
| COMCAT§ | |||||
| Traditions | 0¶ | NA | 1/143 (1%) | ||
| Emergencies | 2/16 (13%)¶ | NA | 68/143 (48%) | ||
| Recognition | 2/16 (13%)¶ | NA | 1/143 (1%) | ||
| Resources | 0 | NA | 9/143 (6%) | ||
| Health systems | 7/16 (44%)¶ | NA | 62/143 (43%) | ||
| Inevitability | 5/16 (31%)¶ | NA | 0 | ||
| Multiple | 0¶ | NA | 2/143 (1%) | ||
Data are numbers of women and percentages. Percentages might not always add to 100% due to rounding. COMCAT=circumstances of mortality categories. ICD-MM=International Classification of Diseases-Maternal Mortality. InterVA=interpreting verbal autopsy. NA=not applicable.
Other obstetric complications were amniotic fluid embolism (n=1), peripartum cardiomyopathy (n=1), complications of intrauterine fetal demise (n=1), and disseminated intravascular coagulation (n=1).
Other infections were meningitis (n=2), tetanus (n=1), hepatitis (n=1), measles (n=1), and infections not otherwise specified (n=3).
Other non-obstetric causes were stroke (n=1), breast neoplasm (n=1), asthma (n=2), and chronic obstructive pulmonary disease (n=2).
COMCAT definitions are provided in the panel.
India only.