Maternal and perinatal mortality

Question 1

define maternal mortality

Answer 1

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

Question 2

why do mothers die?

Answer 2

Direct deaths are defined as those related to obstetric complications during pregnancy, labour or puerperium (6 weeks) or resulting from any treatment received (87%) Eg: Haemorrhage, Sepsis, Preeclampsia, Obstructed labour or Unsafe Abortion
Indirect deaths are those associated with a disorder, the effect of which is exacerbated by pregnancy (13%) Eg Malaria
Late deaths occur ≥42 days after end of pregnancy but within one year

Question 3

what is the 3 delays model?

Answer 3

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: Mountains, islands, rivers, Lack of transport
Delay in receiving care - Supplies, personnel, Poorly trained personnel with punitive attitude

Question 4

how can we prevennt maternal motality?

Answer 4

Antenatal Care - 4 visits, monitoring weight, blood pressure and proteinuria, folic acid, malaria prophylaxis
Skilled attendant at birth
Emergency Obstetric Care - Clean delivery, Active management of 3rd stage, Parenteral antibiotics/ oxytocics/ magnesium sulphate, Manual removal of placenta/ products of conception, Blood transfusion, Caesarean section / operative delivery

Question 5

define different types of perinatal mortality: Stillbirth, early neonatal death, late neonatal death, perinatal mortality, infant mortality, child mortality.

Answer 5

Stillbirth: Birth of a dead baby after 20/ 24/ 28 weeks of gestation or weighing more than 500 g
Early Neonatal Death: Death of a baby within the first week of life
Late Neonatal Death: Death of a baby within the first 28 days of life
Perinatal Mortality: Includes stillbirth and neonatal mortality
Infant mortality: Death of an infant within the first year of life
Child mortality: Death of a child within the first 5 years of life