ABSTRACT
Cardiovascular disease is the leading cause of indirect maternal deaths in the United States. The top causes include cardiovascular diseases ranking first, combining cardiovascular conditions and cardiomyopathy. These were followed by other medical conditions reflecting preexisting illnesses, infection, hemorrhage, and cardiomyopathy. Global indirect causes of maternal mortality that are of concern and focus include cardiovascular, respiratory, diabetes, and cancer. This burden of disease has identified an important challenge for health care providers to resolve. That is, to coordinate care among specialists to optimize outcomes for most cases. At the national level in the United States, studies have shown a rise in pregnant women with chronic diseases as well, including hypertension, diabetes, and chronic heart disease. Black race, age over 35, and no prenatal care have been identified as major associated characteristics with maternal death in the United States. The California Maternal Quality Care Collaborative has led the nation for widespread adoption of safety bundles and publication of key implementation toolkits.
