Maternal and perinatal mortality Flashcards
what is 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
what is maternal morbidity
Severe health complications occurring in pregnancy and delivery not resulting in death
Maternal mortality ratio
Number of maternal deaths during a given time period per 100 000 livebirths during same time period
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
Lifetime risk of maternal death
Probability of maternal death during a woman’s reproductive life, usually expressed in terms of odds
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.
Maternal Mortality Ratio
The risk associated with each pregnancy, i.e. the obstetric risk.
Maternal Mortality Rate
Takes into account not only the obstetric risk, but also the frequency with which women are exposed to that risk.
Lifetime Risk of Maternal Death
Women’s chance of becoming pregnant as well as dying in pregnancy
Facility Based - Methods for Measuring Maternal Deaths
Health information systems
Registries
Confidential Enquiries
Maternal death review
Audit
Critical Incident audit
Criterion Based Clinical Audit
Population / Community Methods for Measuring Maternal Deaths
Notification by law
Vital registration
Census
Surveys or surveillance
Sisterhood method
Verbal Autopsy
Reasons for Direct deaths
Obstetric complications during pregnancy, labour or puerperium (6 weeks) or resulting from any treatment received (87%)
Eg: Haemorrhage, Sepsis, Preeclampsia, Obstructed labour or Unsafe Abortion
reasons for indirect deaths
Associated with a disorder, the effect of which is exacerbated by pregnancy (13%)
Eg: Malaria
late death reasons
≥42 days but within one year after end of pregnancy
what is the three delays model
Delay in decision to seek care
Lack of understanding of complications
Acceptance of maternal death
Socio-cultural barriers to seeking care
Low social status of women
Delay in reaching care
Geography: Mountains, islands, rivers
Lack of transport
Delay in receiving care
Supplies, personnel
Poorly trained personnel with punitive attitudes
what three things can prevent maternal mortality
Antenatal Care
4 visits, monitoring weight, blood pressure and proteinuria, folic acid, malaria prophylaxis
Skilled attendant at birth
Emergency Obstetric Care
Clean delivery
Active management of 3rd stage
Parenteral antibiotics/ oxytocics/ magnesium sulphate
Manual removal of placenta/ products of conception
Blood transfusion
Caesarean section / operative delivery
Stillbirth
Birth of a dead baby after 20/ 24/ 28 weeks of gestation or weighing more than 500 g
Early Neonatal Death
Death of a baby within the first week of life
Late Neonatal Death
Death of a baby within the first 28 days of life
Perinatal Mortality
includes stillbirth and neonatal mortality
Infant mortality
Death of an infant within the first year of life
Child mortality
Death of a child within the first 5 years of life
what is essential newborn care
Ensuring that the baby is breathing
Starting exclusive breastfeeding right away
Keeping the baby warm
Washing hands before touching the baby
