L44 UK Reproductive Health

Question 1

What is fertility?

Answer 1

Measure of reproductive output usually expressed as a fertility rate: i.e. 2.4 births per woman

Question 2

What is fecundity?

Answer 2

Potential to reproduce (may have no children YET)

Question 3

What is maternal death?

Answer 3

Death of a woman while pregnant or within 42 days of the end of pregnancy from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental cause. It can be a direct cause, indirect (previous existing disease or a disease that developed pregnancy or was aggravated by pregnant), late (42 days to 1 year) our coincidental.

Question 4

What are direct causes of maternal death?

Answer 4

Direct causes of maternal death in order:
- Thrombosis - through DVT or pulmonary embolus. There is an increased risk of clots due to the high levels of oestrogen leading to a hyper coagulatory state. More likely to get a DVT since the blood is thicker, more mobile, weight of uterus on the vein leading to venous stasis from the legs and increased pressure.
- Haemorrhage - large blood sup-ply to the uterus. The placenta has massive sinuses. When the placenta is gone, the bleeding does not stop to the placenta. The contraction of the uterus after the baby is born squeezes the sinuses - sometimes the uterus does not contract well and so there is a lot of blood pouring out of the vagina.
- Psychiatric causes
- Genital Tract Sepsis (puerperal)
- Amniotic fluid embolism - amniotic fluid gets lodged in the pulmonary vasculature and you cannot exchange gases
- Early pregnancy - ectopic pregnancy for example. People die from ectopic pregnancy - the most common place is in the ampulla - this burst leading to blood loss. Also miscarriage.
- Pre-eclampsia - HTN and proteinuria
Anaesthesia
- unsafe abortion
-

Question 5

What is endometritis?

Answer 5

Endometritis is an inflammatory condition of the lining of the uterus and is usually due to an infection. Symptoms include:
• Fever, malaise, rigors, headache
• Abdo pain
• Offensive lochia - lochia is the vaginal discharge after giving birth, containing blood, mucus, and uterine tissue. If offensive it is foul smelling.
• Secondary Postpartum haemorrhage

It is a group A streptococcus bacteria and other gram positive organisms that causes endometritis.