Maternal mortality: evolving trends.

Despite improvement in socioeconomic standards, good and accessible health care facilities the maternal mortality rate in Singapore is not declining. The maternal mortality rate in National University Hospital, Singapore, over a 7 year period 1986-1992 was 22.9 per 100,000 when direct and indirect causes were considered (34.4 per 100,000 when incidental deaths were included). However closer scrutiny reveals that most deaths were not due to the traditional direct causes of haemorrhage, sepsis, embolism or hypertensive disease. Most were due to medical disorders which in their own right carries a high risk to life even without a pregnancy.