{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:39:30Z","timestamp":1788050370992,"version":"build-2784847793"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:00:00Z","timestamp":1612828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["24090101, H30\u2010healthcare\u2010general\u2010014"],"award-info":[{"award-number":["24090101, H30\u2010healthcare\u2010general\u2010014"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pathology International"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>The maternal mortality rate in Japan was 3.5 per 100\u2009000 live births in 2017, similar to that reported in other developed countries. To reduce the number of maternal deaths, a Japanese nationwide registration and analysis system was implemented in 2010. Between January 2010 and April 2018, 367 maternal deaths were reported. Among them, by reviewing 80 autopsy records, the direct obstetric causes of death were identified in 52 women. The major causes of deaths were amniotic fluid embolism and acute pulmonary thromboembolism. The other 26 maternal deaths were associated with indirect obstetric causes including invasive <jats:italic>Group A Streptococcus<\/jats:italic> infection, aortic dissection, cerebral stroke and cardiomyopathies. This review highlights the importance of autopsy in maternal deaths. On analyzing 42 autopsy specimens obtained from registered cases of maternal death during 2012\u20132015, the 36% of causes of death by autopsy were discordant with the clinical diagnosis. Moreover, of the 38% of non\u2010autopsied maternal death, the cause of death could not be clarified from the clinical chart. We emphasized that detailed autopsies are necessary to clarify the precise pathologic evidence related to pregnancy and delivery, especially causes of unexpected death such as amniotic fluid embolism.<\/jats:p>","DOI":"10.1111\/pin.13076","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T18:32:03Z","timestamp":1612981923000},"page":"223-231","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Maternal death analysis based on data from the nationwide registration system in Japan (2010\u20132018)"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3328-5677","authenticated-orcid":false,"given":"Tomoko","family":"Wakasa","sequence":"first","affiliation":[{"name":"Department of Diagnostic Pathology, Nara Hospital Kindai University Nara Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatsue","family":"Ishibashi\u2010Ueda","sequence":"additional","affiliation":[{"name":"Department of Pathology National Cerebral and Cardiovascular Center Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Pathology Osaka Women's and Children's Hospital Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,9]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Latest Demographic Statistics, 2019. 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