Adverse Pregnancy Outcomes Flashcards
How does the WHO (2010) define ‘Maternal Death’?
“The death of a woman while pregnant or within 42 days of the end of the pregnancy from any cause related to or aggravated by the pregnancy or its management, but not from incidental causes.”
What is a ‘Direct’ classification of maternal death?
Resulting from obstetric complications of the pregnant state (pregnancy, labour and puerperium), from interventions, omissions, incorrect treatment or from a chain of events resulting from any of the above.
What is an ‘Indirect’ death?
Resulting from previous existing disease, or disease that developed during pregnancy and which was not the result of direct obstetric causes, but which was aggravated by the physiological effects of pregnancy.
What is a ‘Late’ death?
Occurring between 42 days-1 year after the end of pregnancy that are the result of Direct or Indirect maternal causes.
What is a ‘Coincidental’ death?
From unrelated causes which happen to occur in the pregnancy or puerperium.
What is involved in the quality assessment as part of MBRRACE audits and confidential enquiries?
- Good care, no improvements needed
- Improvements in care* identified - which may have made no difference
- Improvements in care* identified - which may have made a difference
- Referrals
*includes adherence to guidelines, where these exist and have not been followed as well as other improvements which would normally be considered as part of good care but no guidelines exist.
What is HQIP and when would it be needed?
- Health Quality Improvement Partnership
- Evidence of abuse/neglect
- Professional misconduct/abuse/dangerous incompetence
- Dysfunctional department or organisation
What is the Maternal Mortality Rate (2016-2018)?
9.71 per 100,000
What is the leading direct cause of maternal death?
Cardiac disease
What is the leading indirect cause of maternal death?
Thromboembolism & Thrombosis
What are Systemic Biases?
When women have other complex/multiple problems and don’t receive the care they need due to pregnancy, health and other issues. E.g. smoking, obesity, minority ethnic group
What effects our power of analysis?
Low maternal death rates
What is the definition of Perinatal death?
- Stillbirth (UK > 24 weeks gestation)
- Early neonatal deaths (up to 7 days after birth - up to 28 days is EXTENDED perinatal death)
What is a normal BMI?
- 18.5 - 24.9
What is the proportion of women who have increased complications and risk of maternal death due to advanced age?
Threefold >40 RR 3.17(Cl 1.64-6.03) vs 20-24
