Maternal and Perinatal mortality Flashcards
What is 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
What is maternal morbidity?
Severe health complications occurring in pregnancy and delivery not resulting in death
What is the Maternal mortality ratio?
- how do we interpret this?
Number of maternal deaths during a given time period per 100 000 livebirths during same time period
- The risk associated with each pregnancy, i.e. the obstetric risk
What is the Maternal mortality rate?
– how do we interpret this?
: Number of maternal deaths in a given time period per 100 000 women of reproductive age, or woman-years of risk exposure, in same time period
Takes into account not only the obstetric risk, but also the frequency with which women are exposed to that risk.
Lifetime Risk of Maternal Death measures?
Women’s chance of becoming pregnant as well as dying in pregnancy
Methods for Measuring Maternal Deaths - facility based (5)
- Health information systems Registries - Confidential Enquiries - Maternal death review Audit - Critical Incident audit - Criterion Based Clinical Audit
Methods for Measuring Maternal Deaths - population/community based (4)
- Notification by law
- Vital registration
- Census
- Surveys or surveillance
- Sisterhood method
- Verbal Autopsy
What is the main body which assesses enquiries?
MBRRACE which stands for Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK
Why do mothers die? - DIRECT deaths - give examples of what may happen
Obstetric complications during pregnancy, labour or puerperium (6 weeks) or resulting from any treatment received (87%)
Why do mothers die? - INDIRECT deaths
- give an example
Associated with a disorder, the effect of which is exacerbated by pregnancy (13%)
Eg: Malaria
Why do mothers die? - LATE deaths
≥42 days but within one year after end of pregnancy
biggest causes of maternal death worldwide ?
unsafe abortion and PPH
Causes of Maternal Death : In the UK
, cardiac disease was the biggest cause of maternal deaths in the UK
ethnicity with the greatest risk of dying?
black and asian
The 3 Delays Model - what are they?
Delay in decision to seek care
Delay in reaching care
Delay in receiving care
Describe the 3 delays model ? DECISION TO SEEK CARE
decision :
- Lack of understanding of complications
- Acceptance of maternal death
- Socio-cultural barriers to seeking care
- Low social status of women
Describe the 3 delays model - DELAY IN REACHING CARE
Geography: Mountains, islands, rivers
Lack of transport
Describe the 3 delays model - DELAY IN RECEIVING CARE
Supplies, personnel
Poorly trained personnel with punitive attitudes
How can we prevent maternal mortality? - Antenatal care
4 visits, monitoring weight, blood pressure and proteinuria, folic acid, malaria prophylaxis
How can we prevent maternal mortality? at birth?
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
Perinatal deaths are far more common than ?
maternal deaths even globally.
2 words to describe timeline of still birth
Antepartum
Intra partum
an early neonatal death is?
late?
1 week
1 month
infant and child mortality age?
1 year
5 years
what is STILLBIRTH defined as?
Birth of a dead baby after 20/ 24/ 28 weeks of gestation or weighing more than 500 g
What is an Early Neonatal Death?
Death of a baby within the first week of life
What is an late Neonatal Death?
Death of a baby within the first 28 days of life
What is Perinatal Mortality?
Includes stillbirth and neonatal mortality
What is Infant mortality?
Death of an infant within the first year of life
What is child mortality?
Death of a child within the first 5 years of life
Why do babies die?
40% remained unexplained
- termination, fetal, cord, congenital, materal, infection etc
Children in sub-Saharan Africa are more likely to die by?
14 times
Essential Newborn Care (4)
- Ensuring that the baby is breathing
- Starting exclusive breastfeeding right away
- Keeping the baby warm
- Washing hands before touching the baby
Packages/plans include?
Integrated Maternal Child Health Packages
Every Newborn Action Plan
