Maternal and perinatal mortality

Question 1

Maternal mortality

Answer 1

The death of a woman while pregnant or within 42 days of termination - but NOT accidental causes

Question 2

Maternal morbidity

Answer 2

Severe health complications occurring in pregnancy and delivery not resulting in death

Question 3

Why is maternal mortality a public health indicator?

Answer 3

The greatest gap - between rich and poor

Question 4

Maternal mortality ratio

Answer 4

number of maternal deaths in a given time period per 100 000 livebirths during the same period

Question 5

Maternal mortality rate

Answer 5

Number of maternal deaths in a given time period per 100 000 women of reproductive age in the same time period

Question 6

Lifetime risk of maternal death

Answer 6

probability of maternal death during a woman’s reproductive life - odds

Question 7

Proportionate mortality ratio

Answer 7

maternal deaths as proportion to all female deaths of those of reproductive age (15-49) in a given time period

Question 8

What does the maternal mortality ratio show?

Answer 8

risk associated with each pregnancy - obstetric risk

Question 9

What does the maternal mortality rate show?

Answer 9

obstetric risk and frequency with which women are exposed to that risk

Question 10

What does the lifetime risk of maternal death show?

Answer 10

women’s risk of becoming pregnant and dying while pregnant

Question 11

Facility based methods for measuring maternal death (4)

Answer 11

health info systems
registries
confidential enquiries
audit - critical incident, standards

Question 12

Population based methods for measuring maternal death

Answer 12

notification by law
vital registration
census
surveys or surveillance - sisterhood method or verbal autopsy

Question 13

Direct deaths of mothers

Answer 13

related to obstetric complications during pregnancy, labour or puerperium (6 weeks) or resulting from any treatment received

Question 14

What % of maternal deaths are direct?

Answer 14

87

Question 15

Examples of direct maternal deaths

Answer 15

haemorrhage 
sepsis 
pre-eclampsia 
unsafe abortion 
obstructed labour

Question 16

Indirect deaths of mothers

Answer 16

associated with a disorder, the effect of which is exacerbated by pregnancy

Question 17

What % of maternal deaths are indirect?

Answer 17

13

Question 18

Example of indirect maternal death

Answer 18

malaria

Question 19

Late maternal deaths

Answer 19

occur more than 42 days but less than a year of pregnancy

Question 20

causes of maternal deaths worldwide

Answer 20

sepsis-haemorrhage-unsafe abortion-hypertensive-obstructed labour-other

Question 21

3 delays model

Answer 21

1. delay in decision to seek care
2. delay in reaching care
3. delay in receiving care

Question 22

Delay in decision to seek care

Answer 22

lack of understanding of complications
acceptance of maternal death
socio-cultural barriers to seeking care
low social status of women

Question 23

Delay in reaching care

Answer 23

geographical eg rivers

lack of transport

Question 24

Delay in receiving care

Answer 24

supplies, personnel

poorly trained personnel with punitive attitude

Question 25

3 ways to prevent maternal mortality

Answer 25

antenatal care
skilled attendant at birth - minimum of midwife
emergency obstetric care

Question 26

Antenatal care - what is done to prevent maternal mortality?

Answer 26

4 visits

weight, bp, proteinuria, folic acid, malaria prophylaxis

Question 27

Who is the minimum skilled attendant required at birth?

Answer 27

midwife

Question 28

Emergency obstetric care - what is done to prevent maternal mortality?

Answer 28

Clean delivery 
active management of 3rd stage 
parenteral antibiotics/oxytocics/magnesium sulphate to prevent eclampsia 
manual removal of placenta 
blood transfusion 
caesarean

Question 29

stillbirth

Answer 29

birth of a dead baby after 20/24/28 weeks or >500g

Question 30

early neonatal death

Answer 30

death of a baby within first week of life

Question 31

late neonatal death

Answer 31

death of a baby within first 28 days of life

Question 32

perinatal mortality

Answer 32

includes stillbirth and neonatal mortality

Question 33

infant mortality

Answer 33

death of an infant within 1st year of life

Question 34

child mortality

Answer 34

death of a child within first 5 years of life

Question 35

Why do babies die?

Answer 35

mostly unknown
congenital anomaly
cord, fetal, maternal, infection, abortion, placenta

Question 36

4 essential newborn care steps

Answer 36

ensure baby is breathing
start new born on breastfeed right away
keep baby warm
wash hands before touching baby