Maternal and perinatal mortality Flashcards
Maternal mortality
The death of a woman while pregnant or within 42 days of termination - but NOT accidental causes
Maternal morbidity
Severe health complications occurring in pregnancy and delivery not resulting in death
Why is maternal mortality a public health indicator?
The greatest gap - between rich and poor
Maternal mortality ratio
number of maternal deaths in a given time period per 100 000 livebirths during the same period
Maternal mortality rate
Number of maternal deaths in a given time period per 100 000 women of reproductive age in the same time period
Lifetime risk of maternal death
probability of maternal death during a woman’s reproductive life - odds
Proportionate mortality ratio
maternal deaths as proportion to all female deaths of those of reproductive age (15-49) in a given time period
What does the maternal mortality ratio show?
risk associated with each pregnancy - obstetric risk
What does the maternal mortality rate show?
obstetric risk and frequency with which women are exposed to that risk
What does the lifetime risk of maternal death show?
women’s risk of becoming pregnant and dying while pregnant
Facility based methods for measuring maternal death (4)
health info systems
registries
confidential enquiries
audit - critical incident, standards
Population based methods for measuring maternal death
notification by law
vital registration
census
surveys or surveillance - sisterhood method or verbal autopsy
Direct deaths of mothers
related to obstetric complications during pregnancy, labour or puerperium (6 weeks) or resulting from any treatment received
What % of maternal deaths are direct?
87
Examples of direct maternal deaths
haemorrhage sepsis pre-eclampsia unsafe abortion obstructed labour
Indirect deaths of mothers
associated with a disorder, the effect of which is exacerbated by pregnancy
What % of maternal deaths are indirect?
13
Example of indirect maternal death
malaria
Late maternal deaths
occur more than 42 days but less than a year of pregnancy
causes of maternal deaths worldwide
sepsis-haemorrhage-unsafe abortion-hypertensive-obstructed labour-other
3 delays model
- delay in decision to seek care
- delay in reaching care
- delay in receiving care
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
geographical eg rivers
lack of transport
Delay in receiving care
supplies, personnel
poorly trained personnel with punitive attitude
3 ways to prevent maternal mortality
antenatal care
skilled attendant at birth - minimum of midwife
emergency obstetric care
Antenatal care - what is done to prevent maternal mortality?
4 visits
weight, bp, proteinuria, folic acid, malaria prophylaxis
Who is the minimum skilled attendant required at birth?
midwife
Emergency obstetric care - what is done to prevent maternal mortality?
Clean delivery active management of 3rd stage parenteral antibiotics/oxytocics/magnesium sulphate to prevent eclampsia manual removal of placenta blood transfusion caesarean
stillbirth
birth of a dead baby after 20/24/28 weeks or >500g
early neonatal death
death of a baby within first week of life
late neonatal death
death of a baby within first 28 days of life
perinatal mortality
includes stillbirth and neonatal mortality
infant mortality
death of an infant within 1st year of life
child mortality
death of a child within first 5 years of life
Why do babies die?
mostly unknown
congenital anomaly
cord, fetal, maternal, infection, abortion, placenta
4 essential newborn care steps
ensure baby is breathing
start new born on breastfeed right away
keep baby warm
wash hands before touching baby
