Maternal and Perinatal mortality

Question 1

What is 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

What is maternal morbidity?

Answer 2

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

Question 3

What is the Maternal mortality ratio?

• how do we interpret this?

Answer 3

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

Question 4

What is the Maternal mortality rate?

– how do we interpret this?

Answer 4

: 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.

Question 5

Lifetime Risk of Maternal Death measures?

Answer 5

Women’s chance of becoming pregnant as well as dying in pregnancy

Question 6

Methods for Measuring Maternal Deaths - facility based (5)

Answer 6

- Health information systems
Registries
- Confidential Enquiries
- Maternal death review
Audit
- Critical Incident audit
- Criterion Based Clinical Audit

Question 7

Methods for Measuring Maternal Deaths - population/community based (4)

Answer 7

• Notification by law
• Vital registration
• Census
• Surveys or surveillance
• Sisterhood method
• Verbal Autopsy

Question 8

What is the main body which assesses enquiries?

Answer 8

MBRRACE which stands for Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK

Question 9

Why do mothers die? - DIRECT deaths - give examples of what may happen

Answer 9

Obstetric complications during pregnancy, labour or puerperium (6 weeks) or resulting from any treatment received (87%)

Question 10

Why do mothers die? - INDIRECT deaths

• give an example

Answer 10

Associated with a disorder, the effect of which is exacerbated by pregnancy (13%)
Eg: Malaria

Question 11

Why do mothers die? - LATE deaths

Answer 11

≥42 days but within one year after end of pregnancy

Question 12

biggest causes of maternal death worldwide ?

Answer 12

unsafe abortion and PPH

Question 13

Causes of Maternal Death : In the UK

Answer 13

, cardiac disease was the biggest cause of maternal deaths in the UK

Question 14

ethnicity with the greatest risk of dying?

Answer 14

black and asian

Question 15

The 3 Delays Model - what are they?

Answer 15

Delay in decision to seek care
Delay in reaching care
Delay in receiving care

Question 16

Describe the 3 delays model ? DECISION TO SEEK CARE

Answer 16

decision :

• Lack of understanding of complications
• Acceptance of maternal death
• Socio-cultural barriers to seeking care
• Low social status of women

Question 17

Describe the 3 delays model - DELAY IN REACHING CARE

Answer 17

Geography: Mountains, islands, rivers

Lack of transport

Question 18

Describe the 3 delays model - DELAY IN RECEIVING CARE

Answer 18

Supplies, personnel

Poorly trained personnel with punitive attitudes

Question 19

How can we prevent maternal mortality? - Antenatal care

Answer 19

4 visits, monitoring weight, blood pressure and proteinuria, folic acid, malaria prophylaxis

Question 20

How can we prevent maternal mortality? at birth?

Answer 20

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 21

Perinatal deaths are far more common than ?

Answer 21

maternal deaths even globally.

Question 22

2 words to describe timeline of still birth

Answer 22

Antepartum

Intra partum

Question 23

an early neonatal death is?

late?

Answer 23

1 week

1 month

Question 24

infant and child mortality age?

Answer 24

1 year

5 years

Question 25

what is STILLBIRTH defined as?

Answer 25

Birth of a dead baby after 20/ 24/ 28 weeks of gestation or weighing more than 500 g

Question 26

What is an Early Neonatal Death?

Answer 26

Death of a baby within the first week of life

Question 27

What is an late Neonatal Death?

Answer 27

Death of a baby within the first 28 days of life

Question 28

What is Perinatal Mortality?

Answer 28

Includes stillbirth and neonatal mortality

Question 29

What is Infant mortality?

Answer 29

Death of an infant within the first year of life

Question 30

What is child mortality?

Answer 30

Death of a child within the first 5 years of life

Question 31

Why do babies die?

Answer 31

40% remained unexplained

- termination, fetal, cord, congenital, materal, infection etc

Question 32

Children in sub-Saharan Africa are more likely to die by?

Answer 32

14 times

Question 33

Essential Newborn Care (4)

Answer 33

• Ensuring that the baby is breathing
• Starting exclusive breastfeeding right away
• Keeping the baby warm
• Washing hands before touching the baby

Question 34

Packages/plans include?

Answer 34

Integrated Maternal Child Health Packages

Every Newborn Action Plan