Maternal and Perinatal Mortality Flashcards
What was the number of global maternal deaths in 2013?
289,000
What percentage of cases of maternal mortality and morbidity are in less developed countries?
> 99%
What percentage of maternal mortality and morbidity is preventable?
> 80%
What number of women experience severe maternal morbidity?
> 20 million
How is maternal health a public health indicator?
Greatest gap is between rich and poor countries
What problems of measurement is maternal health subject to?
Subject to technical and operational problems
- under-reporting
- mis-classification
- incomplete vital registration
What is maternal mortality?
The death of a woman while pregnant or within 42 days of pregnancy, irrespective of the duration and site of 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
What is the maternal mortality ratio?
Number of maternal deaths during a given time period per 100,000 live births during the same time period
What is the 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 the same period
What is the lifetime risk of maternal death?
Probability of maternal death during woman’s reproductive life, usually expressed in terms of odds
What is the proportionate mortality ratio?
Maternal deaths as proportion of all female deaths of those of reproductive age - usually defined as 15-19 years - in a given time period
What does maternal mortality ratio represent?
The risk associated with each pregnancy i.e. the obstetric risk
What does maternal mortality ratio take into account?
Not only the obstetric risk but also the frequency with which women are exposed to that risk
What are the facility based methods for measuring maternal deaths?
Health information systems Registries Confidential enquiries Maternal death review Audit - critical incident audit, criterion based clinical audit
What are the population/community base methods for measuring maternal deaths?
Notification by law
Vital registration
Census
Surveys or surveillance
What are direct maternal deaths?
Defined as those related to obstetric complications during pregnancy, labour or puerperium or resulting from any treatment received
What are indirect maternal deaths?
Those associated with a disorder, the effect of which is exacerbated by pregnancy
What are late maternal deaths?
Occur 42 or more days after the end of the pregnancy but within 1 year
What are some causes of maternal deaths?
Sepsis and other maternal infections Complications of unsafe abortion Haemorrhage Indirect causes Hypertensive disorders Obstructed labour Other maternal conditions Underlying causes e.g. malnutrition
What are the components of the 3 delays model?
Delay in decision to seek care
Delay in reaching care
Delay in receiving care
What might result in 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
What might result in delay in reaching care?
Mountains, islands, rivers - physical barriers, poor organisation
What might result in delay in receiving care?
Supplies, personnel
Poorly trained personnel with punitive attitude
Finances
How can we prevent maternal mortality?
Antenatal care - 4 visits - monitoring weight, BP and proteinuria - folic acid - malaria treatment/prevention Skilled attendant at birth Access to emergency obstetric care - clean delivery - active management of 3rd stage of labour - parenteral antibiotics/oxytocics/magnesium sulphate - manual removal of placenta/products of conception - blood transfusion - Caesarean section/operative delivery
What is the sustainable development goal 3.1?
By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
What is the sustainable development goal 5.2?
Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation
What is the sustainable development goal 5.6?
Ensure universal access to sexual and reproductive health and reproductive rights
Currently, what are the two key aspects of the continuum of maternal care?
Ensuring maternal health needs with a life cycle approach
Providing maternal health care at the household, community and institutional level
Who should be present at every delivery?
A qualified health worker
What are the priorities for achieving sustainable development goals related to maternal health?
Prioritise quality maternal health services that respond to the local specificities of need and meet emerging challenges
Promote equity through universal coverage of quality maternal health services, including for the most vulnerable women
Increase the resilience and strength of health systems by optimising the health workforce, and improve facility capability
Guarantee sustainable finances for maternal-perinatal health
Accelerate progress through evidence, advocacy and accountability
What is stillbirth?
Birth of a dead baby after 20/24/28 weeks of gestation or weighing more than 500 grams
What is early neonatal death?
Death of a baby within the first week of life
What is late neonatal death?
Death of a baby within the first 28 days of life
What is perinatal mortality?
Includes stillbirth and neonatal mortality
What is infant mortality?
Death of an infant within the first year of life
What is child mortality?
Death of a child within the first 5 years of life
What is the stillbirth rate?
Number of stillbirths per 1000 births
What is the neonatal mortality rate?
Number of deaths within the first 28 days per 1000 live births
What is the infant morality rate?
Number of deaths under 1 year per 1000 live births
What is the under 5 mortality rate?
Number of deaths between birth and 5 years of age per 1000 live births
How many children under the age of 5 died in 2015?
5.9 million
Children in Sub-Saharan Africa are how many times more likely to die before the age of 5 than children in developed regions?
14 times more likely
How can we prevent infant morality?
Antenatal care mitigated through healthcare providers
Intranatal care mitigated through skilled attendance at delivery
Postnatal care mitigated through healthcare providers and mothers/relatives
Early identification of danger signs during intranatal care and postnatal care
Targeted interventions for cyclicality of neonatal deaths in scarred families
Behaviour change, communications and counselling
What is essential new born care?
Ensuring baby is breathing
Starting newborn on exclusive breastfeeding right away
Keeping the baby warm
Washing hands before touching the baby
What is MDG goal 4?
2/3rds reduction in child mortality by 2015
Between 1990 and 2015, how many of the 195 countries met the MDG 4?
62 of the 195
What is the SDG 3.2?
End preventable deaths of newborns and under 5 children by 2030
Target of under 5 mortality of 25 or less per 1000 live births by 2030
What are the components of the early newborn action plan?
Strengthen and invest in care during labour, delivery and first week of life
Improve quality of maternal and newborn care
Reach every woman and newborn to reduce inequities
Harness the power of parents, families and communities
Count every newborn - measurement, programme tracking and accountability
