ICD-10 also introduces two terms related to maternal death: pregnancy-related death and late maternal death. Pregnancy-related death is defined as the death of a woman while pregnant or within 42 days of the end of her pregnancy, regardless of cause.
Late maternal death is defined as the death of a woman from direct or indirect causes more than 42 days but less than 1 completed year after the end of the pregnancy.
Maternal deaths are classified as: * Direct--obstetric causes * Indirect--existing conditions aggravated by pregnancy or its management * Incidental--unrelated to pregnancy The ICD includes two additional definitions of maternal death: Late maternal death
: The death of a woman from direct or indirect obstetric causes, more than 42 days but less than one year after termination of pregnancy.
The Tenth Revision of the International Classification of Diseases (ICD-10) defines a maternal death as "the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes." In recognition of the fact that the 42-day limit is somewhat arbitrary, given that modern life-sustaining procedures and technologies can prolong dying and delay death, the ICD-10 introduced a new category: late maternal death
. Late maternal death
is defined as the "death of a woman from direct or indirect obstetric causes more than 42 days but less than one year after termination of pregnancy."
Therefore, a new category of late maternal death
was introduced, defined "as the death of a woman from direct or indirect obstetric causes more than 42 days but less than one year after termination of pregnancy" The definition of maternal death cannot be applied when the precise cause of death is not known.
(10) It defines an early maternal death as the death of a woman while pregnant, during an abortion or within 42 days of termination of pregnancy, from any cause related to or aggravated by pregnancy or its management, but not by accidental or incidental causes, and late maternal death between 43 days and one year after delivery or abortion.
Late maternal deaths (10 cases, 18%) were included because they had been counted in the previous study.
Based on snowball sampling data and according to ICD-10, we classified them as six pregnancy-related deaths, irrespective of the cause of death (cases 1, 3, 4, 5, 8, 11), and one late maternal death (case 9).
In the early 1990s the definition in the International Classification of Diseases 9 (ICD-9) was expanded by the World Health Organization to include deaths occurring up to one year from the end of pregnancy (late maternal deaths) and deaths from any cause during the puerperium (pregnancy-related maternal death).
In addition to small differences in data sources, the study differs from other recent global analyses in its inclusion of late maternal deaths
(those from six weeks to one year after delivery) and in its treatment of deaths among women with HIV; on the basis of the limited data available from previous studies, the researchers assumed that 12% of HIV-related deaths during pregnancy and the first year postpartum can be attributed to maternal causes.
Similarly, traumatic injuries, homicides and suicides have been an alarming source of maternal mortality following inclusion of late maternal deaths
into the estimates.
Late maternal deaths
are often--perhaps usually--missed.