ABSTRACT
In the Confidential Enquiries into Maternal Deaths (CEMD) report for 2000–2002 there were 17 deaths classified as directly due to haemorrhage, 11 deaths due to ectopic pregnancy and one due to genital tract trauma. The number of direct haemorrhage deaths is higher than in previous reports due to an increase in the number of cases of postpartum haemorrhage. A potentially fatal haemorrhage occurs in 1 in 1,000 obstetric deliveries, and this equates to about 600—700 life-threatening haemorrhages a year in the UK. Tachycardia may be the only sign of haemorrhage until 30—40% of the blood volume has been lost. Both miscarriage and termination of pregnancy can result in haemorrhage. There were 11 deaths due to ectopic pregnancy reported in the CEMD report for 2000–2002, of which eight sought medical care. Mechanical manoeuvres may be of value in reducing haemorrhage. Severe obstetric haemorrhage is often further complicated or even caused by coagulopathy.
