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The aim of this study is to present an extensive overview concerning the specific cardiovascular causes of maternal death and to identify avoidable contributing care factors related to these deaths.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We assessed all cases of maternal death due to cardiovascular disorders collected by a\u00a0systematic national confidential enquiry of maternal deaths published by the Dutch Maternal Mortality and Morbidity Committee on behalf of the Netherlands Society of Obstetrics and Gynaecology over a\u00a021-year period (1993\u20132013) in the Netherlands.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>There were 96\u00a0maternal cardiovascular deaths (maternal mortality rate due to cardiovascular diseases 2.4\/100,000 liveborn children). Causes were aortic dissection (<jats:italic>n<\/jats:italic>\u202f=\u200920, 21%), ischaemic heart disease (<jats:italic>n<\/jats:italic>\u202f=\u200917, 18%), cardiomyopathies (including peripartum cardiomyopathy and myocarditis, <jats:italic>n<\/jats:italic>\u202f=\u200920, 21%) and (unexplained) sudden death (<jats:italic>n<\/jats:italic>\u202f=\u200927, 28%). Fifty-five percent of the deaths occurred postpartum (<jats:italic>n<\/jats:italic>\u202f=\u200955, 55%). Care factors that may have contributed to the adverse outcome were identified in 27\u00a0cases (28%). These factors were patient-related in 40% (pregnancy against medical advice, underestimation of symptoms) and healthcare-provider-related in 60% (symptoms not recognised, delay in diagnosis, delay in referral).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The maternal cardiovascular mortality ratio is low in the Netherlands and the main causes of maternal cardiovascular mortality are in line with other European reports. In a\u00a0minority of cases, care factors that were possibly preventable were identified. Women with cardiovascular disease should be properly counselled about the risks of pregnancy and the symptoms of complications. Education of care providers regarding the incidence, presentation and diagnosis of cardiovascular disease during pregnancy is recommended.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s12471-019-01340-w","type":"journal-article","created":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T16:02:51Z","timestamp":1574870571000},"page":"27-36","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Maternal mortality due to cardiovascular disease in the Netherlands: a\u00a021-year experience"],"prefix":"10.1007","volume":"28","author":[{"name":"Dutch Maternal Mortality and Morbidity Committee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Lameijer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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