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PASS Sem 4 > 1) Maternal and Child Public Health; > Flashcards

1) Maternal and Child Public Health; Flashcards

1
Q

List some effects that can interfere with a
women’s birth experience.

A
  • General health
  • Access to healthcare
  • Skilled birth attendance (accredited health professional)
  • Socioeconomic status
  • Health literacy (ability of individual to find, understand and use information for themselves and others)
  • Advocacy
  • Empowerment
  • Housing and sanitation
  • Socio-cultural context
  • Infrastructure
  • Family and peer support
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2
Q

Summarise pregnancy

A
  • 280 days / 40 weeks
  • Divided into 3 periods of equal length (trimesters)
  • Antinatal care should take place throughout
  • With many opportunities for interaction with a healthcare professional
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3
Q

What does Maternal Health mean?

A

Health of a women during pregnancy, childbirth and postpartum period. It includes family planning, pre-conception, prenatal and postnatal care to ensure positive and fulfilling experience in most cases and reduce maternal morbidity and mortality in other cases

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4
Q

What is the UNFPA definition of Maternal Health?

A

‘Good sexual and reproductive health is state of complete physical, mental and social well-being in all matters relating to the reproductive system. It implies that people are able to have a satisfying and safe sex life, the capability to reproduce, and the freedom to decide if, when, and how often to do so.’

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5
Q

What screening tests are available during pregnancy and after your baby has been born?

A
  • Many tests are offered to the mother during pregnancy to check for health conditions that could affect her or her baby
  • They can choose which tests/ if any she wants
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6
Q

What screening test are offered during first 10 weeks of pregnancy?

A
  • Screening for sickle cell and thalassemia
  • These are blood conditions that could be passed onto child through genes
  • Father may also be offered a test
  • If both parents are carriers, they are likely to pass it on
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7
Q

What is offered during 8-12 weeks of pregnancy?

A

Midwife offers blood test for 3 infectious diseases
- HIV
- Hep B
- Syphilis
She can choose which/if any of these to be tested for
Screening for these 3 is best done early in pregnancy but can be offered at any time

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8
Q

What is offered for mothers who have diabetes during pregnancy?

A

Eye screening

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9
Q

What is offered during 10-14 weeks of pregnancy?

A

Offered the combined test
- US and Blood test

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10
Q

What is the combined test looking for?

A

Down’s syndrome
Edward’s syndrome
Patau’s syndrome

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11
Q

What is offered if combined test not done?

A

Quadruple test (up to 20 weeks of pregnancy)

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12
Q

What does the quadruple test look for?

A

Down syndrome only

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13
Q

What is offered between 18-21 weeks of pregnancy?

A

Another US (20 week scan)

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14
Q

What is looked for in the 20 week scan?

A

11 physical condition in the baby
e.g. relating to bones, heart and brain

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15
Q

What is offered just before delivery?

A

Midwife tells mother about screening for newborn baby so she is aware

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16
Q

What examination is done on the baby 3 days after brith?

A

Physical examination
Looks for conditions affecting heart, eyes and hips
If males, testicles checked too
Hearing test also offered (hospital or at home)

17
Q

What tests are done on 5 days old new born?

A

Blood spot test/ heal prick test
Screens for 9 rare but serious conditions like cystic fibrosis

18
Q

What does MMR stand for?

A

Maternal Mortality Ration

19
Q

How do we calculate MMR?

A

All maternal deaths occurring within a reference
period (usually 1 year)
_________________________________________ x100,000
Total # of live births occurring within the reference
period

20
Q

What does MMR represent?

A

REPRESENTS THE RISK ASSOCIATED WITH EACH PREGNANCY
(I.E. THE RISK OF DYING ONCE PREGNANT)

21
Q

What are the pros of MMR?

A
  • Good indicator of general population health and status of women, health services
  • Advocacy purposes
  • There are methods to get around missing data
22
Q

What are the cons of MMR?

A
  • Does not include all pregnancies in the denominator
  • Difficult to get data required
  • Does not detail causes of mortality
23
Q

Where in the world is MMR hgihest?

A

Most prevalent in Africa

24
Q

Epidemiology of maternal deaths

A
  • Around 830 women die per day worldwide from preventable causes related to pregnancy and childbirth
  • 99% occur in low/middle income countries
  • Between 1990 and 2015, global maternal mortality dropped by 44%
25
Q

What does maternal death mean?

A
  • Death of a woman while pregnant or within 42 days of the end of pregnancy (excluding accidental or incidental causes)
  • can be direct or indirect
26
Q

What does late maternal death mean?

A

Direct/ Indirect causes >42 days but <1 year post pregnancy

27
Q

List some causes of maternal mortality world wide (common to least)

A
  • Pre-existing medical conditions exacerbated by pregnancy
  • sever bleeding
  • Pregnancy induced high BP
  • Infections
  • Obstructed labour
  • Abortion complications
  • Blood clots
28
Q

Epidemiology of the UK rates

A
  • Maternal death rate: 8.76 per 10000
  • Thrombosis/thromboembolism: leading causes of direct death
  • Maternal suicides: 3rd largest cause of direct maternal deaths (most important cause of late maternal deaths)
29
Q

List some inequalities in maternal mortality

A
  • Ethnic groups (black 4x, asian 2x more likely than white women)
  • Age
  • Living in more deprived areas (2x more likely)
  • Women with risk factors fro pre-eclampsia to be prescribed from 12 weeks of pregnancy
30
Q

Why do women die?

A
  • Infection
  • Bleeding
  • Hypertension
  • Delivery complications
  • Lack of access to appropriate antenatal care, intrapartum care or postnatal care
  • Multifactorial
31
Q

What does taking a public health approach mean?

A

Thinking about the ‘causes of the causes’
- Starting with populations rather than individuals
- Seeking to understand and address the causes of the causes
- Championing prevention
- Intelligent use of data and evidence base
- Organisations working in partnership with each other and communities

32
Q

What are the 3 phases of delay?

A

Phase 1: delay in deciding to seek care
Phase 2: delay in reaching an adequate health care facility
Phase 3: delay in receiving adequate care once at a facility

33
Q

What is neonatal mortality rate?

A

No. of deaths in first 28 days of life per 1000 live births
Around half of neonatal deaths occur in first 24hrs of life

34
Q

How to reduce neonatal mortality rate?

A
  • Safe birth techniques
  • Resuscitation training and equipment
  • Challenging traditional practice: washing babies right away, using non-sterile equipment to cut cord
35
Q

List some RF for premature delivery

A
  • IUGR (small baby)
  • Infection in the womb/ membranes
  • Waters b reading early
  • Cervical or uterine abnormalities
  • Pre-eclampsia (blood vessels don’t fully transform, it’s likely that the placenta won’t develop properly because it won’t get enough nutrients)
  • Lifestyle factors: smoking, illicit drug use
  • Multiple pregnancy
  • Diabetes in pregnancy
36
Q

List some key players in global maternal health

A
  • UNICEF
  • World Health Organisation
  • UNFPA
  • RSPCH
37
Q

What is equity in terms of the mother and baby?

A

All mothers and babies will achieve health outcomes that are as good as the groups with the best health outcomes

PASS Sem 4 (2 decks)

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