Maternal and perinatal mortality Flashcards
Define what maternal mortailty is
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
Define what maternal morbidity is
Severe health complications occurring in pregnancy and delivery not resulting in death
What are the useful measures of maternal mortality?
Maternal mortality ratio
Maternal mortality rate
Lifetime risk of maternal death
Proportionate mortality ratio
What does the maternal mortality ratio measure?
Number of maternal deaths during a given time period per 100,000 livebirths during same time period
It represents the risk associated with each pregnancy, i.e. the obstetric risk.
What is the maternal mortality rate?
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
This takes into account not only the obstetric risk, but also the frequency with which women are exposed to that risk
What is lifetime risk of maternal death?
Probability of maternal death during a woman’s reproductive life, usually expressed in terms of odds
This shows women’s chance of becoming pregnant as well as dying in pregnancy
What is the 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 is maternal mortality in the UK?
9.2 per 100,000
(2015-2017)
When measuring maternal mortality, we differentiate between direct and indirect maternal deaths
What does direct deaths mean?
Obstetric complications during pregnancy, labour or puerperium (6 weeks) or resulting from any treatment received
eg - Haemorrhage, Sepsis, Preeclampsia, Obstructed labour or Unsafe Abortion
87% of maternal deaths
When measuring maternal mortality, we differentiate between direct and indirect maternal deaths
What does indirect deaths mean?
Deaths associated with a disorder, the effect of which is exacerbated by pregnancy
13% of maternal deaths
eg Malaria
What is meant by ‘late deaths’?
≥42 days but within one year after end of pregnancy
What are the main causes of maternal deaths worldwide?
Haemorrhage
Unsafe abortion
Sepsis
Hypertensive disorders
Obstructed labour
Indirect & others
What is the biggest cause of maternal deaths in the UK?
Cardiac disease
*an indirect cause of maternal deaths*
Where do the most maternal deaths happen?
Sub-saharan Africa
South asia
‘The 3 delays’ model was a model that theorises that maternal deaths occurred because of delays at 3 crucial stages
What are these stages and what causes fall under them?
1) 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
2) Delay in reaching care:
- Geography
- Lack of transport
3) Delay in receiving care:
- Supplies, personnel (numbers)
- poor training of personnel with punitive attitudes
