Maternal and Perinatal Mortality

Question 1

what is maternal mortality?

Answer 1

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

Question 2

what is maternal morbidity?

Answer 2

severe health complications occuring in pregnancy and delivery not resulting in death

Question 3

what is the maternal mortality ratio?
how can we interpret it?

Answer 3

no. maternal deaths during a given time period per 100,000 live births during the same time period.
- 223 per 100,000 live births in 2020
- The risk associated with each pregnancy, i.e. the obstetric risk.

Question 4

what is the maternal mortality rate?
how can we interpret it?

Answer 4

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
- Takes into account not only the obstetric risk, but also the frequency with which women are exposed to that risk.

Question 5

describe the lifetime risk of maternal death
- how can we interpret it?

Answer 5

Lifetime risk of maternal death: Probability of maternal death during a woman’s reproductive life, usually expressed in terms of odds
- Women’s chance of becoming pregnant as well as dying in pregnancy

Question 6

describe the proportionate mortality ratio

Answer 6

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.

Question 7

why do mothers die?

Answer 7

highest maternal mortality rates are in sub-saharan africa and south asia

Question 8

where do mothers die?

Answer 8

• direct deaths - obstetric complications during pregnancy, labour or puerperium or resulting from any treatment received (87%) e.g. haemorrhage, sepsis
• indirect deaths - associated with a disorder, the effect of which is exacerbated by pregnancy (13%) e.g. malaria
• late deaths: >/= 42 days but within one year after end of pregnancy

Question 9

how can we reduce maternal mortality?

Answer 9

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 Abx/oxytotics/magnesium sulphate
- manual removal of placenta/products of conception
- blood transfusion
- c-section/operative delivery

Question 10

Thaddeus and Maine’s 3 delays model proposes that maternal deaths occurred because of delays at three crucial stages:

Answer 10

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

Question 11

stillbirth definition

Answer 11

• birth of a dead baby after 20/24/28 weeks gestation or weighing more than 500g

Question 12

early neonatal death definition

Answer 12

death of a baby within 1st week of life

Question 13

late neonatal death definition

Answer 13

• death of a baby within first 28 days of life

Question 14

perinatal mortality definition

Answer 14

• includes stillbirth and neonatal mortality

Question 15

infant mortality definition

Answer 15

death of an infant within the 1st year of life

Question 16

child mortality definition

Answer 16

death of a child within 1st 5 years of life

Question 17

why do babies die?

Answer 17

Question 18

where is neonatal mortality the highest?

Answer 18

sub-saharan africa
south asia