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OBGYN 4MB > Perinatal Morbidity and Mortality > Flashcards

Perinatal Morbidity and Mortality Flashcards

1
Q

Why do we monitor perinatal morbidity and mortality?

A
  1. To improve the health of mothers, babies and children
  2. By carrying out confidential enquiries and related work on an nationwide basis
  3. By widely disseminating the findings and recommendations
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2
Q

Where is the information on perinatal morbidity and mortality?

A

Perinatal Mortality Report from the National Perinatal Epidemiology Centre (NPEC)

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3
Q

Define stillbirth

A

Baby delivered without signs of life from 24wks gestation or with a birth weight >/=500g

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4
Q

Define neonatal death

A

Death of a live born baby occurring before 28 completed days after birth
Early = <7 completed days
Late = 7-27 completed days

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5
Q

Define perinatal death

A

Stillbirths + early neonatal deaths

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6
Q

Define live birth

A

Delivery of an infant, which, after complete separation from its mother, shows signs of life

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7
Q

Define overall perinatal mortality rate (PMR)

A

Number of stillbirths and early neonatal deaths per 1000 births (live births and stillbirths from 24wks gestation or weighing >/=500g )

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8
Q

Define adjusted PMR

A

Perinatal mortality rate excluding perinatal deaths associated with or due to a congenital malformation

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9
Q

Define Parity

A

The number of completed pregnancies, whether live birth or stillbirth, of at least 24wks gestation or with a birth weight >/=500g

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10
Q

Define Gravida

A

The number of times the mother has been pregnant, irrespective of duration

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11
Q

Define intrauterine growth restriction (IUGR)

A

This is a situation where growth is good initially in pregnancy but the drops later in pregnancy (e.g. fetus on 97th centile dropping to 50th centile)

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12
Q

Define small for gestational age (SGA)

A

A baby that has a birthweight less than the 10th percentile of all babies with the same gender and gestational age

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13
Q

What was the PMR in 2015?

A
  • 7 deaths per 1000 births

- Adjusted PMR (for congenital abnormalities) = 4.3 deaths per 1000 births

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14
Q

What was the stillbirth rate in 2015?

A
  • 4.5 per 1000 births
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15
Q

What was the early neonatal death rate in 2015?

A
  • 2.5 per 1000 live births
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16
Q

List the risk factors for stillbirths and neonatal deaths

A
  1. Lower socioeconomic class
  2. <17 or >40 years
  3. Smokers and drug abusers
  4. Obesity
  5. Pre-existing medical conditions (HTN, psychiatric disorder, renal disease, diabetes, cardiac disease, epilepsy)
  6. Poor nutrition
  7. Multiple pregnancies
  8. High parity
  9. Ethnicity (Irish traveller, Asian or Black)
  10. Previous pregnancy related problems
  11. Carriers of genetic disorders
  12. Previous stillbirth or preterm birth
  13. Infertility treatments
17
Q

How can the sex of the infant affect perinatal mortality?

A
  • Female infant at greater risk of stillbirth

- Male infant at greater risk of early neonatal death

18
Q

What is the PMR like for multiple pregnancies?

A

PMR is 3.9 times that of singleton pregnancies

19
Q

How does gestation affect perinatal mortality?

A

Almost 70% of perinatal deaths in 2015 were associated with delivery before 37wks gestation

20
Q

How does birthweight impact on perinatal mortality?

A

The most represented birthweight in cases of perinatal death was in the range 500-999g

21
Q

List the primary causes of stillbirth

A
  1. Major congenital anomaly (27%)
  2. Specific placental conditions (maternal vascular malperfusion) (24%)
  3. Unexplained (15%)
  4. Infection (chorioamnionitis) (8%)
  5. Specific fetal condition (TTTS, hydrops) (8%)
  6. Ante/intrapartum haemorrhage (praevia, abruption) (7%)
  7. Mechanical factors (cord around neck/entanglement/prolapse) (6%)
  8. IUGR (3%)
22
Q

What are the most common congenital anomalies that cause stillbirth?

A
  1. Chromosomal disorders (65.8%)
  2. Other (16.5%)
  3. Central nervous system (3.8%)
  4. CVS (3.8%)
  5. Musculo-skeletal system (3.8%)
  6. Multiple anomalies (3.8%)
  7. Urinary tract (2.5%)
23
Q

List the primary causes of neonatal deaths

A
  1. Major congenital anomaly (59%)
  2. Respiratory (25%)
  3. Neuro (HIE/IVH) (10%)
  4. Infection (Sepsis, RTI, Meningitis) (2%)
  5. Unexplained (2%)
  6. Other specific causes (tumours) (1%)
  7. Pre-viable (<22/40) (0.6%)

OBGYN 4MB (25 decks)

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