- Susan Bewley, consultant obstetrician1,
- Lin Foo, academic foundation trainee2,
- Peter Braude, professor of obstetrics and gynaecology3
- 1Kings Health Partners, Women’s Services, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 7EH, UK
- 2Royal London Hospital, Barts and London NHS Trust, London, UK
- 3Kings College London, Division of Women’s Health, St Thomas’ Hospital, London UK
The fundamental measure of women’s health and maternity services—maternal mortality—has been creeping up for two decades in the United Kingdom,1 and more recently in the United States, Denmark, Austria, Canada, and Norway.2 The first published case report of a maternal death related to in vitro fertilisation (IVF) predicted that maternal morbidity and mortality would rise with increasing use of assisted reproductive technologies as a result of pregnancies at an older age, multiple pregnancies, and pre-eclampsia.3
The most comprehensive work on this topic to date, which used multiple sources of information, including 24 years of the Dutch maternal mortality database,4 examined the late effects of ovarian hyperstimulation syndrome and other deaths related to IVF to derive estimates of mortality. With 23 pregnancy related deaths and conservative assumptions, the study showed convincingly that overall mortality in IVF pregnancies was higher than the maternal mortality rate in the general population in the Netherlands. Compared with the national maternal mortality rate (12.8/100 000), it was estimated that 6/100 000 were directly related to IVF and 42.5/100 000 were related to …
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