Maternal deaths in South Africa Acute collapse a matter of concern

Objective: The objective of this paper was to review the maternal deaths classified as acute collapse in South Africa as reported through the confidential maternal deaths process. Methods: All the chapters discussing maternal deaths in the Saving Mothers triennial reports were reviewed to assess the cumulative impact of deaths classified as acute collapse. Information were analysed to illustrate factors emerging when combining data, and were scrutinised for changes over the past 12 years. Results: Between 1999 and 2010 a total of 517 maternal deaths were classified acute collapse as the primary cause of death. The final cause of death was unknown in 280 cases (42.7%). Cardiac, respiratory and immune system failure were the most common known final or contributory causes of death. In 490 cases where assessment could be made regarding health care workers, the most common factors were associated with problem recognition, diagnosis, monitoring of patients and substandard care. Conclusion: Acute collapse is a condition reflecting systems affecting health care. Strengthening the poolof skills and introduction of a standardised observation policy should result in improved outcomes.Keywords: Maternal death; Acute collapse; Health syste