[Maternal mortality, its definition and assessment. Report of maternal mortality at the Bamberg Gynecologic Clinic 1963-1988].

During the period of observation from 1963-1988 (26 years) 16 maternal deaths during pregnancy, birth and post partum were registered among 59,681 births at the Departm. of Obstetr. and Gynaec. Bamberg. This corresponds to a maternal mortality ratio of 0.26%. Thirteen of the deaths were direct material deaths, three cases of death belong in the category of indirect deaths. In this timeframe 4,257 (7.13%) C-sections were done. The rate of C-sections has almost tripled during the last 26 years, increasing from 3.6% in 1963 to 10.1% in 1988. In 10 cases maternal death followed a C-section. Taking the complete period of observation into account, the mortality rate after C-section of 2.34% is about 20 times higher than the mortality risk after vaginal delivery. This heightened mortality risk after C-section is clearly diminishing. In the years 1973-1982 the C-section mortality rate was only 6 times higher than maternal deaths after vaginal deliveries.