Maternal 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 maternal mortality ratio used for?

Answer 3

Evaluating risk associated with each pregnancy

Question 4

What are some facility based methods for measuring maternal deaths?

Answer 4

Health information systems
Registries
Confidential Enquiries
Maternal death review
Audit

Question 5

What are some community based methods of measuring maternal deaths?

Answer 5

Notification by law
Vital registration
Census
Surveys or surveillance

Question 6

What are the main direct causes of maternal death?

Answer 6

Obstetric complications like:
Haemorrhage
Sepsis
Preeclampsia
Obstructed labour
Unsafe abortion

Question 7

What are the main indirect causes of maternal death?

Answer 7

Associated with disorders exacerbated by pregnancy e.g. Malaria

Question 8

How has maternal mortality and indirect cause rates changed over time?

Answer 8

Overall maternal mortality is falling

Indirect causes have stayed static

Question 9

What is the biggest cause of maternal death in the UK?

Answer 9

Cardiac disease

Question 10

How much greater is the chance of death during pregnancy for a black woman compared to a white woman?

Answer 10

5x

Question 11

How much greater is the chance of death during pregnancy for an Asian woman compared to a white woman?

Answer 11

2x

Question 12

What are some factors causing delays in decision to seek care?

Answer 12

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

Question 13

What are some factors causing delay in reaching care?

Answer 13

Geography: Mountains, islands, rivers

Lack of transport

Question 14

What are some factors causing delay in receiving care?

Answer 14

Supplies
Personnel
Poorly trained personnel with punitive attitude

Question 15

What are the biggest things we can do to prevent maternal death?

Answer 15

Antenatal care
Skilled attendant at birth
Emergency obstetric care

Question 16

What makes up good emergency obstetric care?

Answer 16

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 17

What is a still birth?

Answer 17

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

Question 18

What is early neonatal death?

Answer 18

Death of a baby within the first week of life

Question 19

What is late neonatal death?

Answer 19

Death of a baby within the first 28 days of life

Question 20

What is perinatal mortality?

Answer 20

Includes still birth and neonatal mortality

Question 21

What is infant mortality?

Answer 21

Death of an infant within the first year of life

Question 22

What is child mortality?

Answer 22

Death of a child within the first 5 years of life

Question 23

What are essential steps in care of a newborn?

Answer 23

Ensure baby is breathing
Starting exclusive breastfeeding right away
Keep baby warm
Wash hands before touching the baby