Global Health in Maternal Child Health Care

Question 1

Maternal Death Definition

Answer 1

• 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)

Question 2

Pregnancy Related Death

Answer 2

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.

Question 3

5 Leading Causes of Maternal Death in LMIC

Answer 3

• Bleeding 25%
• Infection 15%
• Unsafe Abortion 13%
• Eclampsia 12%
• Obstructed Labor 8%

Question 4

Causes of Postpartum Hemorrhage

Answer 4

Question 5

Postpartum Hemorrhage Management

Answer 5

Question 6

Hypertensive Disorders of Pregnancy

Answer 6

•Preeclampsia

• hypertension
• proteinuria
• edema

•Eclampsia

Question 7

Signs and Symptoms of Preeclampsia

Answer 7

Question 8

Risk Factors for Preeclampsia

Answer 8

Question 9

Malaria

Answer 9

• 10,000 maternal deaths/year
• 75,000-200,000 infant deaths/year

Question 10

Malaria in Pregnancy

Answer 10

Question 11

Malaria Chemoprophylaxis in Pregnancy

Answer 11

2 doses of sulfadoxine/pyrimethamine starting after quickening

Question 12

HIV/AIDS

Answer 12

Question 13

Puerperal Sepsis

Answer 13

Question 14

Obstructed Labor

Answer 14

• 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”

Question 15

Major Causes and Consequences of Prolonged or Obstructed Labor

Answer 15

Question 16

Obstructed Labor Risk Factors

Answer 16

• Young maternal age
• Small stature
• Contracted pelvis
• Large baby
• Malpresentation
• Female circumcision

Question 17

Obstructed Labor Management

Answer 17

Question 18

Unsafe Abortions

Answer 18

•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

Question 19

Unsafe Abortion Methods and Procedures

Answer 19

Question 20

Causes of Maternal Death Worldwide and Evidence-Based Interventions

Answer 20

Question 21

Basic Emergency Obstetric Care

Answer 21

• 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

Question 22

Comprehensive Emergency Obstetric care

Answer 22

• Cesarean section
• Safe blood transfusion

Question 23

What Can Be Done?

Answer 23

Question 24

Questions to Ask - “The Four Cs”

Answer 24

• 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?

Question 25

Birth Rate

Answer 25

Birth rate = Number of Live Births/ Midyear Population x 1000

Question 26

Death Rate

Answer 26

Total Number of Deaths/Midyear Population x 1000

Question 27

Rate of Natural Increase

Answer 27

Rate of Natural Increase = Birth rate – Death rate [as %]

Question 28

Infant Mortality Rate

Answer 28

Infant Mortality rate = Deaths in infants < 1 year old/Number of Live Births x 1000

Question 29

Under 5 Mortality Ratio

Answer 29

Under-Five Mortality Ratio = No. of children dead before 5th birthday per 1000 live births

Question 30

Maternal Mortality Ratio

Answer 30

Maternal Mortality Ratio= Number of deaths from puerperal causes per 100,000 100,000 live births

Question 31

Total Fertility

Answer 31

Total Fertility [lifetime] = Average no. of lifetime live births per woman