OBJECTIVE: To describe the Italian Obstetric Surveillance System (ItOSS) investigating maternal death through incident case reporting and confidential enquiries.
METHODS: All maternal deaths occurred in any public and private health facility in 8 Italian regions covering 73% of national births have been notified to the ItOSS. Every incident case is confidentially reviewed to assess quality of care and establish the cause and avoidability of the death.
FINDINGS: A total of 106 maternal deaths among 1 455 545 live births have been notified to the surveillance system in 2013-17. Haemorrhage, sepsis and hypertensive disorders of pregnancy are the leading causes of direct maternal deaths due to obstetric causes.
CONCLUSIONS: A maternal mortality surveillance system, including incidence reporting and confidential enquiries along with a retrospective analysis of administrative data sources, emerged as the best option for case ascertainment and for preventing avoidable maternal deaths.
- Abortion, Induced/mortality
- Cause of Death
- Cesarean Section/mortality
- Death Certificates
- Emigrants and Immigrants
- Maternal Mortality
- Medical Record Linkage
- Population Surveillance/methods
- Pregnancy Complications/mortality
- Prospective Studies
- Puerperal Disorders/mortality
- Reproductive Techniques, Assisted/mortality