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Repro > Maternal & Perinatal Death > Flashcards

Maternal & Perinatal Death Flashcards

1
Q

Define Maternal Mortality

A

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

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2
Q

What is maternal morbidity?

A

Any severe health complication occuring in pregnancy/delivery but not resulting in death

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3
Q

What are the different ways we measure maternal mortality?

A

Maternal Mortality Ratio
Maternal Mortality Rate
Lifetime Risk of Maternal Death
Proportionate Mortality Ratio

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4
Q

What is the Maternal Mortality Ratio?

A

No. of deaths per 100,000 livebirths over the same period

Shows the obstetric risk

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5
Q

Whats the maternal mortality rate?

A

The no. of maternal deaths per 100,000 women of childbearing age

combines obstetric risk with frequency of exposure to that risk

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6
Q

Whats the Lifetime risk of maternal death?

A

Odds of maternal death during a womans repdocutive life

Combines obstetric risk with risk of getting pregnant

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7
Q

What do we use Lifetime risk for?

A

Evaluating the effectiveness of Family planning interventions

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8
Q

What is proportionate mortality ratio?

A

Maternal deaths as a proportion of all deaths for women of child-bearing age (15-49)

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9
Q

What are the categories for maternal death?

A

Direct (87%) - Deaths related to obstetric complications or treatment

Indirect (13%) - Deaths related to a disorder exacerbated by pregnancy

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10
Q

What are the main causes of direct maternal death?

A
  • Haemorrhage
  • Sepsis
  • Pre-eclampsia
  • Obstructed Labour
  • Unsafe Abortion
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11
Q

What are the main causes of indirect maternal death?

A

Diseases like Malaria worldwide but Cardiac disease in the UK.

Direct causes 87% of maternal deaths worldwide but indirect actually predominates in the UK

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12
Q

There are also socio-cultural reasons mothers-to-be die, how do we categorise them?

A

The 3 delays model:

  • Delay in seeking Care
  • Delay in Reaching Care
  • Delay in Receiving Care
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13
Q

Why would there be a delay in seeking care?

A
  • Lack of understanding
  • Acceptance of maternal death
  • Cultural resistance to care
  • Low social status of women
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14
Q

What measures are important to reduce maternal death?

A
  • Antenatal Care
  • Skilled Attendant (midwife) at the birth
  • Basic Emergency Obstetric Care, Comprehensive if possible
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15
Q

Whats included in basic antenatal care?

A

4 visits to monitor:

  • Weight
  • BP; Proteinuria
  • Folic Acid
  • Malaria Prophylaxis

Cuts maternal death

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16
Q

Whats included in basic Emergency Obstetric Care?

A
  • Clean Delivery
  • Active Management of 3rd stage
  • Parenteral Abx, Oxytocin & MgSO4 as required
  • Manual removal of placenta/products of conception
17
Q

What needs to be available to turn basic into Comprehensive Emergency Obstetric Care?

A

Blood Transfusions and C-section need to be available to be classed as comprehensive EBC

18
Q

What are the different terms for describing foetal/baby death based on time period?

A
  • Stillbirth
  • Early
    Neonatal death
  • Late Neonatal Death
  • Perinatal Mortality
  • Infant Mortality
  • Child Mortality
19
Q

Define Stillbirth?

A

Birth of a dead baby after 24wks or >500g

Split into antepartum and intrapartum

20
Q

Define Neonatal Death?

A 
Early = During 1st wk of life
Late = During 1st 28days of life
21
Q

Define Perinatal Mortality?

A

Combination of stillbirths and neonatal deaths

22
Q

Define infant and child mortality?

A 
Infant = Death during 1st year
Child = death during 1st 5 yrs
23
Q

How can be prevent baby deaths?

A

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)

24
Q

What are the main mechanisms for obtaining data on maternal death?

A 
Facility Based
•	Health information systems
•	Registries
•	Confidential Enquiries
•	Maternal death review
•	Audit
•	Critical Incident audit
•	Criterion Based Clinical Audit
Population / Community based
•	Notification by law
•	Vital registration
•	Census
•	Surveys or surveillance
•	Sisterhood method
•	Verbal Autopsy
25
Q

What does the sisterhood method involve

A

go into village and ask women whether they know of any deaths between women they know.

26
Q

What does a verbal autopsie involve?

A

method you use to do the sisterhood methods- speak to people who might have witnessed a death who might have information on how this happened.

27
Q

Which is the organisation which collects data on maternal deaths in the UK?

A

MBRRACE: mothers and babies: Reducing risk through audits and confidential enquires across the UK.

28
Q

What are late maternal deaths?

A

Those which occur 42 days after birth but within 1 year.

29
Q

Why would there be a delay in reaching care?

A

Geographical/transport

Lack of transport

30
Q

Why would there be a delay in receiving care?

A

Supplies, personnel

Poorly trained personnel with punitive attitude

31
Q

Where is there a highest number of maternal deaths?

A

sub-saharan africa and Afghanistan.

32
Q

What is the highest cause of stillbirths?

A

maternal

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