Maternal and Perinatal Mortality Flashcards
definition of 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.
definition of maternal morbidity
severe health complications occurring in pregnancy and delivery not resulting in death
define maternal mortality ratio
Number of maternal deaths during a given time period per 100,000 livebirths during same time period
define maternal mortality rate
Number of maternal deaths in given time period per 100,000 women of reproductive age, or woman-years of risk exposure, in same time period
define lifetime risk of maternal death
Probability of maternal death during a woman’s reproductive life, usually expressed in terms of odds
define 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
what does maternal mortality ratio mean?
risk associated with pregnancy
what does maternal mortality rate mean?
obstetric risk + frequency with which women are exposed to that risk
what is lifetime rsk of maternal death?
a measure of women’s risk of becoming pregnant as well as the risk of dying while pregnant
methods for measuring maternal deaths: facility based
o Health information systems o Registries o Confidential enquiries o Maternal death review o Audit § Critical incident audit § Criterion based clinical audit
methods for measuring maternal deaths: population/community based
o Notification by law o Vital registration o Census o Surveys or surveillance § Sisterhood method – have you had a sister that died? § Verbal autopsy – what happened?
what are direct maternal deaths and main causes?
o Those related to obstetric complications during pregnancy, labour or puerperium (6 weeks) or resulting from any treatment received
o Haemorrhage, sepsis, pre-eclampsia, obstruction and unsafe abortion
what are indirect maternal deaths and main causes?
o Those associated with a disorder, the effect of which is exacerbated by pregnancy
o Could have died anyway
what are late maternal deaths and main causes?
o Occur >42 days after end of pregnancy but within one year
o HIV
name the 3 delays model and describe each one
- Delay in decision to seek care
a. Lack of understanding of complications
b. Acceptance of maternal death
c. Socio-cultural barriers to seeking care
d. Low social status of women - Delay in reaching care
a. Mountains, islands, rivers – poor organisation - Delay in receiving care
a. Supplies, personnel
b. Poorly trained personnel with punitive attitude
c. Finances
how can we prevent maternal mortality?
antenatal care
skilled attendant at birth
emergency obstetric care
antenatal care requirements
4 visits, monitoring weight, BP, proteinuria, folic acid, malaria
minimum skilled birth attendent
midwife
minimum facilities needed for emergency obstetric care
a. Clean delivery
b. Active management of 3rd stage
c. Parenteral antibiotics/oxytocic’s/magnesium sulphate (pre-eclampsia)
d. Manual removal of placenta/products of conception
e. Comprehensive emergency obstetric care
Figure 4 When do Mothers Die?
Figure 3 Where do Mothers Die? Mostly Sub-Saharan Africa, Afghanistan, South Asia
i. Blood transfusion
ii. Caesarean section/operative delivery
define stillbirth
Birth of a dead baby after 20/24/28 weeks (depending on the availability of neonatal care) of gestation weighing more than 500g
define late neonatal death
withing first 28 days
define early neonatal death
within first week
define perinatal mortality
stillbirth + neonatal mortality
define infant mortality
death within 1st year
define child mortality
death within first 5 years
define still birth rate
number of still births per 1000 births
define neonatal mortality rate
Number of deaths within the first 28 days per 1000 live births
define infant morality rate
Number of deaths under 1 year per 1000 live births
define child mortality rate
Number of deaths between birth and 5 years of age per 1000 live births
what are the essential newborn care requirements
- Ensuring that the baby is breathing
- Starting the newborn on exclusive breastfeeding right away
- Keeping the baby warm
- Washing hands before touching the baby
describe the every newborn action plan
- Strengthen and invest in care during labour, delivery, 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
