Maternal & Perinatal Death Flashcards
Define Maternal Mortality
Death while pregnant or <42 days post-termination from any cause related to or aggravated by the pregnancy or its management irrespective of duration/location of pregnancy
What is maternal morbidity?
Any severe health complication occuring in pregnancy/delivery but not resulting in death
What are the different ways we measure maternal mortality?
Maternal Mortality Ratio
Maternal Mortality Rate
Lifetime Risk of Maternal Death
Proportionate Mortality Ratio
What is the Maternal Mortality Ratio?
No. of deaths : 100,000 livebirths over the same period
Shows the obstetric risk
Whats the maternal mortality rate?
The no. of maternal deaths per 100,000 women of childbearing age
combines obstetric risk with frequency of exposure to that risk
Whats the Lifetime risk of maternal death?
Odds of maternal death during a womans repdocutive life
Combines obstetric risk with risk of getting pregnant
What do we use Lifetime risk for?
Evaluating the effectiveness of Family planning interventions
What is proportionate mortality ratio?
Materanl deaths as a proportion of all deaths for women of child-bearing age (15-49)
What are the categories for maternal death?
Direct (87%) - Deaths related to obstetric complications or treatment
Indirect (13%) - Deaths related to a disorder exacerbated by pregnancy
What are the main causes of direct maternal death?
- Haemorrhage
- Sepsis
- Pre-eclampsia
- Obstructed Labour
- Unsafe Abortion
What are the main causes of indirect maternal death?
Diseases like Malaria worldwide but Cardiac disease in the UK.
Direct causes 87% of maternal deaths worldwide but indirect actually predominates in the UK
There are also socio-cultural reasons mothers-to-be die, how do we categorise them?
The 3 delays model:
- Delay in seeking Care
- Delay in Reaching Care
- Delay in Receiving Care
Why would there be a delay in seeking care?
- Lack of understanding
- Acceptance of maternal death
- Cultural resistance to care
- Low status of women
What measures are important to reduce maternal death?
- Antenatal Care
- Skilled Attendant (midwife) at the birth
- Basic Emergency Obstetric Care, Comprehensive if possible
Whats included in basic antenatal care?
4 visits to monitor:
- Weight
- BP & Proteinuria
- Folic Acid
- Malaria Prophylaxis
Cuts maternal death
Whats included in basic Emergency Obstetric Care?
- Clean Delivery
- Active Management of 3rd stage
- Parenteral Abx, Oxytocin & MgSO4 as required
- Manual removal of placenta/products of conception
What needs to be available to turn basic into Comprehensive Emergency Obstetric Care?
Blood Transfusions and C-section need to be available to be classed as comprehensive EBC
What are the different terms for describing foetal/baby death based on time period?
- Stillbirth
- Early
Neonatal death - Late Neonatal Death
- Perinatal Mortality
- Infant Mortality
- Child Mortality
Define Stillbirth?
Birth of a dead baby after 24wks or >500g
Split into antepartum and intrapartum
Define Neonatal Death?
Early = During 1st wk of life Late = During 1st 28days of life
Define Perinatal Mortality?
Combination of stillbirths and neonatal deaths
Define infant and child mortality?
Infant = Death during 1st year Child = death during 1st 5 yrs
How can be prevent baby deaths?
Essential Newborn Care:
- Ensure breathing
- Start on exclusive breastfeeding ASAP
- Keep Warm
- Wash hands prior to touching baby
On a global policy level we have the Every Newborn Action Plan (ENAP)
