Maternal & Perinatal Mortality

Question 1

What is the global burden of maternal and perinatal mortality?

Answer 1

• 1 maternal death every 2 minutes
• Maternal deaths globally appear to be decreasing, however this could be due to reduced rate of pregnancy or better contraceptions.
• 99% of maternal deaths occur in less developed countries, with 80% of maternal deaths being preventable

Question 2

What are the different measures of maternal mortality?

Answer 2

Maternal mortality ratio - Number of maternal deaths during a given time period per 100,000 livebirths during that same period

Maternal mortality rate - Number of maternal deaths in a given time period per 100,000 woman of reproductive age.

Lifetime risk of maternal death - probability of maternal death during a womans reproductive life, usually expressed in terms of odds

Proportionate mortality ration - Maternal deaths as proportion of all female deaths of those of reproductive age (15-49 years)

Question 3

Where is data regarding maternal deaths collected from?

Answer 3

• Health information systems
• Registries
• Notification by law
• Census

Question 4

What do the different measurements of maternal deaths actually tell us?

Answer 4

Maternal mortality ratio - risk associated with each pregnancy

Maternal mortality rate - Takes into account not only obstetric risk but also the frequency with which woman are exposed to that risk

Lifetime risk of maternal death - useful in family planning as it is a measure of a womans risk of becoming pregnant as well as their risk of dying whilst pregnant

Question 5

What are the major options for reducing the magnitude of maternal mortality at a population method?

Answer 5

1) Antenatal care - 4 visits monitoring weight, BP, proteinuria, folic acid
2) Skilled attendant at birth
3) Emergency obstetric care - clean delivery, active management of 3rd stage, parenteral antibiotics, manual removal of placenta, blood transfusion, C-section

Question 6

What is infant mortality and up until when can it occur?

Answer 6

Death of an infant up until 1 years old

Question 7

What is perinatal mortality?

Answer 7

Stillbirth and neonatal mortality

Question 8

What is the leading cause of stillbirths?

Answer 8

Unexplained

Question 9

What are the essential steps that can be taken to prevent perinatal mortality?

Answer 9

1 - ensuring that baby is breathing

2 - Start baby on exclusive breastfeeding right away

3 - Keep baby warm

4 - Wash hands before touching the baby

Question 10

What is the leading causes of maternal mortality in the UK?

Answer 10

• Cardiac disease (indirect)
• Haemorrhage (direct

Question 11

In the developing world, what are the 3 reasons used in the ‘3 delays model’ as to why there is a high rate of maternal mortality?

Answer 11

1) Delay in decision to seek care
2) Delay in reaching care
3) Delay in receiving care