Global Health in Maternal Child Health Care Flashcards
Maternal Death Definition
- A MATERNAL DEATH is 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
- Direct maternal death is the result of obstetric complications of the pregnant state (pregnancy, delivery, and postpartum), from interventions, omissions, incorrect treatment, or from a chain of events resulting from any of the above (examples: hemorrhage, preeclampsia/eclampsia, complications of anesthesia or cesarean section)
- Indirect maternal death is the result of previous existing disease, or diseases that developed during pregnancy, and which were not due to direct obstetric causes but aggravated by physiological changes of pregnancy (example: deaths due to aggravation of a pre-existing cardiac or renal disease)
Pregnancy Related Death
A PREGNANCY RELATED DEATH is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death.
5 Leading Causes of Maternal Death in LMIC
- Bleeding 25%
- Infection 15%
- Unsafe Abortion 13%
- Eclampsia 12%
- Obstructed Labor 8%
Causes of Postpartum Hemorrhage
Postpartum Hemorrhage Management
Hypertensive Disorders of Pregnancy
•Preeclampsia
- hypertension
- proteinuria
- edema
•Eclampsia
Signs and Symptoms of Preeclampsia
Risk Factors for Preeclampsia
Malaria
- 10,000 maternal deaths/year
- 75,000-200,000 infant deaths/year
Malaria in Pregnancy
Malaria Chemoprophylaxis in Pregnancy
2 doses of sulfadoxine/pyrimethamine starting after quickening
HIV/AIDS
Puerperal Sepsis
Obstructed Labor
- Usually due to cephalopelvic disproportion, but may also be due to fetal malpresentation
- Important cause of both fetal and maternal morbidity and mortality – “most disabling of all maternal conditions”
Major Causes and Consequences of Prolonged or Obstructed Labor
Obstructed Labor Risk Factors
- Young maternal age
- Small stature
- Contracted pelvis
- Large baby
- Malpresentation
- Female circumcision
Obstructed Labor Management
Unsafe Abortions
•Mortality
- 80,000 maternal deaths per year
- Cause of 1 in 8 maternal deaths
• Morbidity
-10-50% of women who undergo unsafe abortions need medical care for complications
Unsafe Abortion Methods and Procedures
Causes of Maternal Death Worldwide and Evidence-Based Interventions
Basic Emergency Obstetric Care
- Administration of antibiotics, oxytocics, or anticonvulsants
- Manual removal of placenta
- Removal of retained products following miscarriage or abortion
- Assisted vaginal delivery with forceps or vacuum extraction
Comprehensive Emergency Obstetric care
- Cesarean section
- Safe blood transfusion
What Can Be Done?
Questions to Ask - “The Four Cs”
- What do you Call your condition?
- What do you think Caused your condition?
- How do you Cope with your condition?
- What Concerns do you have regarding the condition?
Birth Rate
Birth rate = Number of Live Births/ Midyear Population x 1000
Death Rate
Total Number of Deaths/Midyear Population x 1000
Rate of Natural Increase
Rate of Natural Increase = Birth rate – Death rate [as %]
Infant Mortality Rate
Infant Mortality rate = Deaths in infants < 1 year old/Number of Live Births x 1000
Under 5 Mortality Ratio
Under-Five Mortality Ratio = No. of children dead before 5th birthday per 1000 live births
Maternal Mortality Ratio
Maternal Mortality Ratio= Number of deaths from puerperal causes per 100,000 100,000 live births
Total Fertility
Total Fertility [lifetime] = Average no. of lifetime live births per woman
