Maternity claims represent the highest value and second highest number of clinical negligence claims reported to NHS Resolution. The three most frequent categories of claim were those relating to management of labour (14.05%), caesarean section (13.24%) and cerebral palsy (10.65%). Two of these categories, namely cerebral palsy and management of labour, along with CTG interpretation, were also the most expensive and together accounted for approximately 70% of the total figure of £3.1 billion, paid out on or expected to be paid, for all maternity claims.

Amniotic fluid embolus is the eighth most common cause of all maternal deaths, down one place from the previous edition of this book [2, 5]. At 0.35 per 100 000 maternities (95% CI 0.15–1.39) it has declined from the fourth to the fifth leading cause of direct maternal deaths in the United Kingdom. Maternal case fatality rates are between 11% and 32% in the United Kingdom, Australia and the United States [9, 4, ref surveillance]. There is a fall in case mortality rates which is probably due to high-level supportive care and diagnosis of milder cases [6].

Women who died or who had permanent neurological injury were more likely to present with cardiac arrest (83% vs. 33%, P < 0.001), be from ethnic-minority groups (adjusted odds ratio [AOR] 2.85; 95% CI 1.02–8.00), to have had a hysterectomy (OR 2.49; 95% CI 1.02–6.06) and were less likely to receive cryoprecipitate (OR 0.30; 95% CI 0.11–0.80) [1].