The Dublin conference was very well attended with 300 multidisciplinary delegates from both Southern and Northern Ireland. The high attendance rate reflected the impact recommendations from previous CEMACH reports have had on informing health professionals within the Irish maternity services. 

Speaking at the conference, the Chief Medical Officers from Ireland and Northern Ireland, Dr Tony O’Holohan and Dr M McBride respectively, both endorsed the importance and benefits of confidential maternal death enquiry reports in  advancing quality and safety within the maternity services.

In the triennium 2006-2008, 261 women in the UK died from conditions directly or indirectly related to pregnancy. The maternal mortality rate was 11.39 per 100,000 maternities compared to 13.95 per 100,000 maternities for the previous triennium, 2003-05. As this enquiry is far more inclusive than in other countries, for direct comparison with international figures, the UK maternal death rate was 6.7 per 100,000 live births.

Positive findings of the report were that the maternal mortality rate continues to decline in the UK and there was a significant decrease in maternal mortality rates among those living in the most deprived areas and those in the lowest socio-economic group

However speaking at the conference Professor Gwyneth Lewis, CMACE Director UK, warned against complacency, many of the identified avoidable factors unfortunately remain the same as those identified in previous Enquiries.

Two of the report authors, Dr Ann Harper and Professor Colm O’ Herlihy spoke of the re-emergence of sepsis as the leading cause of direct maternal deaths in this triennium. Many of these deaths were from Group A Streptococcal disease acquired in the community, mirroring a rise in the general population. There has been a significant, decline in deaths from pulmonary embolism and a decline in deaths due to haemorrhage. Obesity was highlighted as becoming a major factor in maternal mortality.

In speaking on the causes of indirect maternal deaths Professor Michael de Swiet emphasised the importance of pre pregnancy counselling and timely consultation with other medical specialities.

Other lessons learnt on midwifery care, anaesthesia and critical care in pregnancy, perinatal psychiatry and the GP perspective were presented by Ms Val Beale, Dr David Hill, Dr Roch Cantwell and Dr Judy Shakespeare respectively, who are all CMACE central assessors.

 In presenting the Top Ten Recommendations of the report, Prof Richard Greene highlighted the relevance and importance of implementing them into clinical practice in Ireland.

Of note the report has for the first time included an aide-memoire for healthcare professionals.  This new chapter ‘Back to basics’, provides a list for the identification and management of the most commonly occurring conditions in pregnancy.       

The Saving Mothers Lives report, Executive Summary and Midwifery summary can be accessed on the CMACE Ireland website www.ucc.ie/en/cmace/ 

Edel Manning

CMACE Ireland Coordinator