Six maternal deaths were recorded at the three Dublin maternity hospitals last year, the highest figure in recent years.

This included three deaths of mothers attending Dublin's Rotunda Hospital for the second year in a row, according to the latest clinical statistics from the hospitals. The Rotunda has now recorded eight maternal deaths between 2009 and 2011.

Writing in the latest clinical report from the Rotunda Hospital, its Master, Dr Sam Coulter Smith said women from disadvantaged communities were over-represented in the hospital's maternal mortality statistics.

He said in 2011, the one direct maternal death recorded was of a woman who did not have any understanding of English and came from a different cultural background.

Two maternal deaths were recorded in 2011 at the National Maternity Hospital, Holles Street. One of these was recorded as being due to sudden adult death syndrome of unknown cause in a woman who was seven months pregnant with twins.

In 2011, one maternal death was recorded at the Coombe, as a result of a sudden unexplained death in epilepsy. One of the mothers attending the Rotunda who died also had epilepsy.

The details of the six 2011 Dublin maternal deaths are as follows:

Rotunda:

1. 40 year-old woman died at 15 weeks gestation. Was diagnosed with advanced breast cancer during pregnancy.

2. 32-year old woman. Did not speak English; booked at 21 weeks gestation. Died at 30 weeks gestation due to cardiac arrest secondary to massive antepartum hemorrhage resulting from placental abruption. This was the one 'direct maternal death' of the three recorded at the Rotunda in 2011.

3. 32-year-old woman who had epilepsy. Discontinued anti-epilepsy drug lamotrigine in early pregnancy due to 'her interpretation of the risk of taking these drugs while pregnant. Was seen at clinic at 12 weeks 'and importance of epilepsy control discussed and retreatment prescscribed after review of risks with lamotrogine'. Despite telephone contact, patient failed to attend further and in mid-pregnancy was found dead at her home. Post-mortem suggested seizure occurred shortly before death.

Holles Street:

1. 35-year old woman - referred from another hospital at 27 weeks. Died 23 days after delivering at 33 weeks gestation. Classified as maternal death secondary to chronic liver failure.

2. 28-year old woman pregnant with twins. During pregnancy, had been given drug treatment at Holles Street for indigestion and a liver condition, cholestasis. Collapsed at home at 29 weeks pregnant and died following unsuccessful CPR at local emergency department. Postmortem recorded death as due to Sudden Adult Death Syndrome of unknown cause.

Coombe:

1. Maternal death reported as due to sudden death in epilepsy (SUDEP) syndrome. Further clinical details are not yet published.

More recently at the Coombe Hospital, there were two maternal deaths recorded in September of this year, both of them in mothers who had delivered by caesarean section. One of the women who died was pregnant with twins, who survived.

These deaths have will not be clinically reported on by the Coombe until next year.

Figures show that 2011 was the worst year for maternal deaths in Dublin hospitals in recent times.

Over the past 10 years, the next highest figure for maternal deaths in Dublin hospitals occurred in 2010, when four deaths were recorded. Between 2002 and 2009 the highest number recorded between the three public Dublin maternity units in a single year was three, and in one year, 2005, there were no maternal deaths.

irishhealth.com recently revealed that Ireland's national maternal mortality rate is twice as high as has been previously reported in official statistics.

The first report from the recently-established Maternal Death Enquiry - MDE Ireland system shows that our maternal death rate is 8 per 100,000 births, compared with 4 per 100,000 reported by the Central Statistics Office (CSO).

The MDE Ireland report, which uses wider criteria for defining maternal death than that used by the CSO, found that in the years 2009 to 2011 inclusive, 25 mothers who attended maternity hospitals with their pregnancies died.

This would have included the six deaths at Dublin hospitals in 2011, but the MDE rerport did not identify where the deaths had occurred.

The Central Statistics Office only recorded one maternal death nationally in 2010, when four were recorded in the Dublin maternity hospitals alone.