Abstract
Background Pregnancy-associated deaths are extremely rare in Germany. Most deaths are from natural
causes, and a range of causes are possible.
Method The deaths of 22 women who died of pregnancy-associated causes and who were autopsied
in the Institute of Forensic Medicine of Justus-Liebig University Gießen between 1992
and 2016 were analyzed.
Results The autopsy results and histological examinations for the majority of women who died
of pregnancy-associated causes between 1992 and 2016 showed that they had died of
natural causes, although complications of pregnancy were a leading cause of death.
Conclusion The death of a pregnant woman should not automatically raise the suspicion of malpractice,
although the question does arise in cases of bleeding complications only detected
at very late stages. Experts must prove that a real mistake was made during treatment
and provide evidence of the causality between malpractice and patient death. Particularly
when well-known complications of pregnancy were present, this is only the case if
poor monitoring resulted in the complication being detected too late or if treatment
was not in accordance with accepted standards of care. The majority of pregnancy-associated
deaths are from natural causes and the death of a pregnant woman does not mean that
medical malpractice was involved, although this accusation is often levelled in cases
where rupture was not immediately diagnosed or in cases of fatal postpartum hemorrhage.
Key words
miscarriage - ectopic pregnancy - HELLP syndrome - pregnancy
