Maternal and Perinatal Mortality

Question 1

What is meant by maternal mortality and morbidity?

Answer 1

• the death of a women while pregnant or within 42 days of termination of pregnancy,
  irrespective of duration and site of pregnancy,
  from any cause related to/aggrevated by the pregnancy or its management,
  but not from accidental or incidental causes
• severe health complications occurring in pregnancy and delivery not resulting in death

Question 2

What is meant by; maternal mortality ratio, maternal mortality rate + lifetime risk of maternal death?

Answer 2

• risk associated with each pregnancy
• obstetric risk and frequency with which women are exposed to that risk
• women’s risk of becoming pregnant and the risk of dying whilst pregnant

Question 3

What are different methods for measuring maternal deaths?

Answer 3

• facility based
• health information systems
• registries
• confidential enquiries
• maternal death review
• audit
• popuation/community based
• notification by law
• vital registration
• census
• surveys/surveillance

Question 4

What is meant by; direct deaths, indirects deaths + late deaths?

Answer 4

• deaths related to obstetric complications during pregnancy, labour or puerperium or resulting from any treatment received (87%)
• e.g. sepsis, haemorrhage
• deaths associated with a disorder, the effect of which is exacerbatedd by pregnancy (13%)
• e.g. malaria
• deaths which occur ≥ 42 days after pregnancy but within 1 year

Question 5

What is the 3 Delays Model?

Answer 5

• delay in decision to seek care
• lack of understanding of complications
• acceptance of maternal death
• socio-cultural barriers
• low social status of women
• delay in reaching care
• geographical
• lack of transport
• delay in receiving care
• supplies, personnel
• poorly trained personnel with punitive attitude

Question 6

How can maternal mortality be prevented?

Answer 6

• antenatal care
• 4 visits
• weight, BP, proteinuria, folic acid, malaria prophylaxis
• skilled attendant at birth
• emergency obstetric care
• clean delivery
• 3rd stage active managment
• parenteral antibiotics/oxytocics/MgSO4
• manual removal of placenta/products of conception
• blood transfusion
• C-section/operative delivery

Question 7

What is meant by; stillbirth, early neonate death, late neonate death, perinatal mortality, infant mortality + child mortality?

Answer 7

• birth of a dead baby after 20/24/28 weeks or weighing > 500g
• death of a baby within the first week of life
• death of a baby within the first 28 days of life
• stillbirth and neonatal mortality
• death of an infant within the first year of life
• death of a child within the first 5 years of life

Question 8

What is some essential newborn care?

Answer 8

• ensuring the baby is breathing
• starting the newborn on exclusive breast feeding
• keeping the baby warm
• washing hands before touching the baby