Underlying causes of maternal death in women with SCD categorized by SCD phenotype, clinical events, and autopsy findings
| Number . | Phenotype . | Age, y . | Parity . | Duration of hospitalization before death . | Estimated time of death . | Groups of underlying causes of death using WHO-ICD 10 mm . | Cause of death . | ||
|---|---|---|---|---|---|---|---|---|---|
| Type of maternal death . | Group name . | Clinical events . | Autopsy findings . | ||||||
| Postintervention period (May 2015 to May 2016) | |||||||||
| 1 | HbSC | 27 | 1 | 5 d | Postpartum day 4 | Indirect obstetric death | Nonobstetric complications | I. ACS | VTE (massive bilateral pulmonary embolism) |
| Sustainability period (June 2016 to December 2019) | |||||||||
| 1 | HbSC | 34 | 3 | 6 d | Postpartum (< 1 wk) | Indirect obstetric death | Nonobstetric complications | I. ACS II. Severe anemia (hyperhemolytic crisis and acute splenic sequestration crisis) III. Pre-eclampsia | I. ACS II. Cerebral edema III. Acute splenic sequestration crisis |
| 2 | HbSC | 21 | 0 | 8 d | Postpartum day 1 | Indirect obstetric death | Nonobstetric complications | I. ACS II. VOC III. Pre-eclampsia | ACS |
| 3 | HbSS | 30 | 0 | 3 d | 23 wk 4 d gestation | Indirect obstetric death | Nonobstetric complications | I. ACS II. VOC III. Severe anemia (Intravascular haemolysis and acute sequestration crisis) | I. ACS II. 1. Severe anemia 2. Acute sequestration crisis |
| 4 | HbSS | 31 | 2 | 5 d | Postpartum day 0 | Direct obstetric death | Obstetric complications | I. Haemorrhagic shock II. Haemoperitoneum post caesarean delivery III. VOC | Haemorrhagic shock with end organ failure |
| 5 | HbSC | 30 | 1 | 6 d | Postpartum day 6 | Indirect obstetric death | Nonobstetric complications | I. ACS (rapidly progressive) II. VOC IIIa. Severe anemia (acute splenic sequestration crisis and intravascular haemolysis) IIIb. Coagulopathy IIIc. Stroke | ACS |
| 6 | HbSS | 33 | 2 | 5 d | Postpartum day 1 | Indirect obstetric death | Nonobstetric complications | I. ACS II. VOC III. Pre-eclampsia | ACS |
| 7 | HbSC | 27 | 1 | 8 d | Postpartum day 0 | Indirect obstetric death | Nonobstetric complications | I. ACS II. VOC III. Gestational hypertension | VTE (massive bilateral venous thromboembolism from left popliteal vein thrombus) |
| 8 | HbSS | 31 | 1 | 3 d | 27 wk 6 d gestation | Indirect obstetric death | Nonobstetric complications | I. CCF II. Severe anemia (Intravascular haemolysis) IIIa. VOC IIIb. Twin gestation | I. CCF II. Dilated cardiomyopathy III. SCD |
| 9 | HbSC | 29 | 2 | 2 d | 24 wk gestation | Indirect obstetric death | Nonobstetric complications | ACS (rapidly progressive) | Not done |
| Number . | Phenotype . | Age, y . | Parity . | Duration of hospitalization before death . | Estimated time of death . | Groups of underlying causes of death using WHO-ICD 10 mm . | Cause of death . | ||
|---|---|---|---|---|---|---|---|---|---|
| Type of maternal death . | Group name . | Clinical events . | Autopsy findings . | ||||||
| Postintervention period (May 2015 to May 2016) | |||||||||
| 1 | HbSC | 27 | 1 | 5 d | Postpartum day 4 | Indirect obstetric death | Nonobstetric complications | I. ACS | VTE (massive bilateral pulmonary embolism) |
| Sustainability period (June 2016 to December 2019) | |||||||||
| 1 | HbSC | 34 | 3 | 6 d | Postpartum (< 1 wk) | Indirect obstetric death | Nonobstetric complications | I. ACS II. Severe anemia (hyperhemolytic crisis and acute splenic sequestration crisis) III. Pre-eclampsia | I. ACS II. Cerebral edema III. Acute splenic sequestration crisis |
| 2 | HbSC | 21 | 0 | 8 d | Postpartum day 1 | Indirect obstetric death | Nonobstetric complications | I. ACS II. VOC III. Pre-eclampsia | ACS |
| 3 | HbSS | 30 | 0 | 3 d | 23 wk 4 d gestation | Indirect obstetric death | Nonobstetric complications | I. ACS II. VOC III. Severe anemia (Intravascular haemolysis and acute sequestration crisis) | I. ACS II. 1. Severe anemia 2. Acute sequestration crisis |
| 4 | HbSS | 31 | 2 | 5 d | Postpartum day 0 | Direct obstetric death | Obstetric complications | I. Haemorrhagic shock II. Haemoperitoneum post caesarean delivery III. VOC | Haemorrhagic shock with end organ failure |
| 5 | HbSC | 30 | 1 | 6 d | Postpartum day 6 | Indirect obstetric death | Nonobstetric complications | I. ACS (rapidly progressive) II. VOC IIIa. Severe anemia (acute splenic sequestration crisis and intravascular haemolysis) IIIb. Coagulopathy IIIc. Stroke | ACS |
| 6 | HbSS | 33 | 2 | 5 d | Postpartum day 1 | Indirect obstetric death | Nonobstetric complications | I. ACS II. VOC III. Pre-eclampsia | ACS |
| 7 | HbSC | 27 | 1 | 8 d | Postpartum day 0 | Indirect obstetric death | Nonobstetric complications | I. ACS II. VOC III. Gestational hypertension | VTE (massive bilateral venous thromboembolism from left popliteal vein thrombus) |
| 8 | HbSS | 31 | 1 | 3 d | 27 wk 6 d gestation | Indirect obstetric death | Nonobstetric complications | I. CCF II. Severe anemia (Intravascular haemolysis) IIIa. VOC IIIb. Twin gestation | I. CCF II. Dilated cardiomyopathy III. SCD |
| 9 | HbSC | 29 | 2 | 2 d | 24 wk gestation | Indirect obstetric death | Nonobstetric complications | ACS (rapidly progressive) | Not done |
I, immediate cause of death; II, underlying cause of death; III, other maternal disease or morbid condition.