16 - Maternal & Perinatal Mortality Flashcards
Define maternal mortality?
The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management (but not from accidental or incidental causes)
define maternal morbidity?
Severe health complications occurring in pregnancy and delivery not resulting in death
% of cases in developing countries and % which are preventable?
> 99% in developing countries,
> 80% preventable
how many measurements are there for maternal mortality?
4
define maternal mortality ratio?
Number of maternal deaths during a given time period per 100 000 livebirths during same time period
define maternal mortality rate?
Number of maternal deaths in a given time period per 100 000 women of reproductive age, or woman-years of risk exposure, in same time period
define lifetime risk of maternal death?
Probability of maternal death during a woman’s reproductive life, usually expressed in terms of odds
define proportionate mortality ratio?
Maternal deaths as proportion of all female deaths of those of reproductive age—usually defined as 15–49 years—in a given time period
How to interpret maternal mortality ratio?
The risk associated with each pregnancy, i.e. the obstetric risk
How to interpret maternal mortality rate?
Takes into account not only the obstetric risk, but also the frequency with which women are exposed to that risk
How to interpret Lifetime Risk of Maternal Death?
Women’s chance of becoming pregnant as well as dying in pregnancy
what are the 2 methods for measuring maternal deaths?
facility based
population/ community based
describe 5 facility based methods for measuring maternal deaths?
Health information systems
Registries
Confidential Enquiries
Maternal death review
Audit
describe 2 types of audits?
Critical Incident audit
Criterion Based Clinical Audit
describe 4 population based methods for measuring maternal deaths?
Notification by law
Vital registration
Census
Surveys or surveillance
describe 2 types of surveys/ surveillance techniques?
Sisterhood method
Verbal Autopsy
3 types of death?
direct
indirect
late
define direct death?
Obstetric complications during pregnancy, labour or puerperium (6 weeks) or resulting from any treatment received
give 5 examples of direct death?
Haemorrhage
Sepsis
Preeclampsia
Obstructed labour
Unsafe Abortion
define indirect death?
Associated with a disorder, the effect of which is exacerbated by pregnancy
give an example of indirect death?
malaria
define late death?
≥42 days but within one year after end of pregnancy
What was the biggest cause of maternal deaths in UK?
cardiac disease
In terms of ethnicity, rank these women from most at risk to least at risk -
White
Asian
Mixed ethnicity
Black
Black - x5
mixed ethnicity - x3
asian - x2
white
in which 2 areas of the world are the majority of maternal deaths?
Sub-Saharan African regions
South Asia
describe the 3 delays model?
1) Delay in decision to seek care
2) Delay in reaching care
3) Delay in recieving care
give 2 examples of delay in decision to seek care?
Lack of understanding of complications
Socio-cultural barriers to seeking care
give 2 examples of delay in reaching care?
geography - mountains, islands etc.
lack of transport
give 2 examples of delay in recieving care?
supplies, personnel
poorly trained personnel with punitive attitudes
3 ways in which we can prevent maternal mortality?
antenatal care
skilled attendant at birth
emergency obstetric care
define stillbirth?
Birth of a dead baby after 20/ 24/ 28 weeks of gestation or weighing more than 500 g
define early neonatal death?
Death of a baby within the first week of life
define late neonatal death?
Death of a baby within the first 28 days of life
define perinatal mortality?
Includes stillbirth and neonatal mortality
define infant mortality?
Death of an infant within the first year of life
define child mortality?
Death of a child within the first 5 years of life
In terms of ethnicity, who is most at risk of neonatal mortality?
Black and Asian ethnicities have higher risk
what is the most common cause of stillbirth?
unknown - most stillbirths are unexplained
give 3 examples of reasons for stillbirth?
congenital anomaly
infection
issues with cord
Give 4 things which make up the essential newborn care advice?
Ensuring that the baby is breathing
Starting exclusive breastfeeding right away
Keeping the baby warm
Washing hands before touching the baby
