Key Learning Points

1. 1. Direct obstetric deaths are those resulting from obstetric complications of the pregnancy state (pregnancy, labour and the puerperium) from interventions, omissions or incorrect treatment, or a chain of events resulting from any of the above.

2. 2. Indirect obstetric deaths are those resulting from previous existing disease or disease that developed during pregnancy and which was not due to direct obstetric causes, but which was aggravated by physiological effects of pregnancy.

3. 3. Indirect or pre-existing disease in pregnancy accounts for three-quarters of maternal deaths in the UK, and has remained stubbornly high in recent years.

4. 4. Maternal morbidity is rising, owing to concurrent medical illness, increasing maternal age, socio-economic factors and obesity. Cardiac disease is the major cause, then death from thromboembolism, followed by neurological causes and all-cause sepsis.

5. 5. Multidisciplinary teams care for the sick mother in different hospital sites. Recent national Royal College of Anaesthetists Maternal Critical Care Guidelines 2018 make general recommendations for optimal teamwork and collaboration on maternity and designated critical care units.