oa South African Medical Journal - The continuing process of learning lessons from maternal deaths : ‘Red flags’ - guest editorial

Volume 108 Number 11
  • ISSN : 0256-9574
  • E-ISSN: 2078-5135



In this CME, maternal mortality associated with chronic hypertension,[ 1] cardiac disease[2] and organophosphate poisoning[3] is discussed to highlight lessons learnt. Maternal mortality rates remain high in South Africa (SA), despite reductions in the number of deaths from non-pregnancy-related infections as a result of the widespread use of antiretroviral therapy by HIV-infected women. This success shows the achievement of focused attention on an epidemic, and the National Department of Health is to be congratulated on this aspect. However, similar successes in the reduction of maternal mortality have not been achieved with regard to deaths due to direct obstetric causes, such as hypertensive disorders of pregnancy, mainly preeclampsia and eclampsia. The reason may be that the entire health system is not functioning well – it should identify pregnant women at risk of pre-eclampsia, triage patients at risk, timeously refer patients to health facilities staffed by specialists, immediately treat patients (judicious lowering of severe hypertension, use of magnesium sulphate for the prevention of convulsions, timeous delivery without causing harm to the mother and baby) and follow national clinical guidelines strictly.

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