Maternal mortality due to cardiac disease in Sri Lanka

<bold>Objective: </bold>To investigate Sri Lankan maternal deaths due to heart disease and to consider low-cost interventions to reduce these deaths.<bold>Methods: </bold>A qualitative study based on retrospective audit of all maternal deaths and late maternal deaths in Sri Lanka caused by cardiac disease in 2004.<bold>Results: </bold>A 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.<bold>Conclusion: </bold>Cardiac 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. [ABSTRACT FROM AUTHOR]