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Questions and Answers

What does the Total Fertility Rate (TFR) represent?

The annual number of maternal deaths per 100,000 live births

The total number of children a woman would have by the end of her reproductive period (correct)

The percent of births attended by untrained traditional birth attendants

The percent of women of reproductive age using contraceptive methods

Which of the following best describes the Contraceptive Prevalence Rate (CPR)?

The annual number of maternal deaths per 100,000 live births

The percent of women of reproductive age using contraceptive methods at a specific time (correct)

The number of perinatal deaths per 1,000 total births

The percent of live births that weigh less than 2,500g

What does the Maternal Mortality Ratio (MMR) indicate?

The percent of women who have access to antenatal care

The percentage of births attended by skilled health personnel

The total number of children a woman has during her reproductive years

The annual number of maternal deaths per 100,000 live births (correct)

Which statement correctly defines Antenatal Care Coverage?

The percent of women attended at least once during pregnancy by skilled health personnel Signup and view all the answers

What does the percent of births attended by skilled health personnel indicate?

The portion of deliveries attended by qualified health professionals, excluding untrained attendants Signup and view all the answers

What does the Availability of Basic Essential Obstetric Care measure?

The number of facilities with functioning basic essential obstetric care per 500,000 population Signup and view all the answers

The Perinatal Mortality Rate (PMR) is defined as what?

The annual number of perinatal deaths per 1,000 total births Signup and view all the answers

Which indicator provides information about low birth weight prevalence?

Percent of live births that weigh less than 2,500g Signup and view all the answers

What does the term 'maternal mortality rate' represent?

The number of maternal deaths per 1,000 women of reproductive age Signup and view all the answers

Which factor is considered a good proxy measure of the quality of intrapartum and immediate postnatal care?

Perinatal mortality rate Signup and view all the answers

What is the threshold for perinatal mortality in developed countries?

Below 10 per 1,000 total births Signup and view all the answers

How is fetal death defined?

Death prior to the complete expulsion from the mother Signup and view all the answers

What does the 'proportion of maternal deaths among deaths of women of reproductive age' measure?

The number of maternal deaths in a specific time period Signup and view all the answers

What percentage of pregnant women is defined as having anemia according to the screening levels mentioned?

110g/l Signup and view all the answers

What defines the prevalence of infertility in women of reproductive age?

Women trying for a pregnancy for two years or more Signup and view all the answers

Which of the following indicators is closely associated with the total fertility rate (TFR)?

Maternal mortality ratio Signup and view all the answers

What is excluded from the calculation of obstetric and gynecological admissions owing to abortion?

Planned termination of pregnancy Signup and view all the answers

What is defined as the total fertility rate (TFR)?

The number of children born to women if they live to the end of childbearing years Signup and view all the answers

Which group is considered when calculating the HIV prevalence among pregnant women?

Those whose blood has been screened for HIV Signup and view all the answers

What demographic indicator is most commonly used to gauge reproductive health services success?

Total fertility rate Signup and view all the answers

Which of the following is NOT a way to prevent the sexual transmission of HIV according to prevention practices?

Avoiding all types of sexual activity Signup and view all the answers

What is the definition of maternal death?

Death occurring during pregnancy or within 42 days of termination Signup and view all the answers

What defines maternal death?

Death of a woman during pregnancy or within 42 days after termination of pregnancy from related complications. Signup and view all the answers

What was the global maternal death rate in 2017?

211 maternal deaths per 100,000 live births. Signup and view all the answers

What percentage of all maternal deaths occurred in low-income countries in 2020?

95% Signup and view all the answers

Which of the following is a significant cause of maternal death?

Complications from delivery. Signup and view all the answers

What is the maternal mortality ratio (MMR)?

The ratio of maternal deaths per 100,000 live births during a specific time period. Signup and view all the answers

What complication accounts for a significant majority of maternal deaths?

Severe bleeding after childbirth. Signup and view all the answers

What might a maternal mortality ratio of 50-250 suggest?

Problems with the quality of labor and delivery care. Signup and view all the answers

How can skilled health professionals affect maternal mortality?

They can save the lives of women and newborns. Signup and view all the answers

Which major complication is a result of unsafe abortion?

Severe bleeding. Signup and view all the answers

What is a main takeaway regarding maternal deaths in 2020?

They are often due to preventable causes. Signup and view all the answers

Study Notes

Istanbul Gelisim University

Institution focused on ecological, economic, and social sustainability
Website: www.gelisim.edu.tr

Department of Nursing (ENG)

Course: Women's Health and Diseases Nursing
Lecturer: Dr. N. Alper Sahbaz, MD

Course Information

Credits: 8 / ECTS: 9
Week: 17
Link: https://gbs.gelisim.edu.tr/en/lesson-details-17-319-12715-2

What We Are Going to Learn This Week

Basic concepts of women's reproductive health indicators
Roles and functions of a women's health nurse

Women's Reproductive Health Indicators

Total fertility rate
Contraceptive prevalence
Maternal mortality ratio
Antenatal care coverage
Availability of basic essential obstetric care
Availability of comprehensive essential obstetric care
Perinatal mortality rate
Prevalence of low birth weight
Prevalence of positive syphilis serology in pregnant women
Prevalence of anemia in women
Percentage of obstetric and gynecological admissions owing to abortion
Reported prevalence of women with genital mutilation
Prevalence of infertility in women
Reported incidence of urethritis in men
Prevalence of HIV infection in pregnant women
Knowledge of HIV-related preventive practices

Total Fertility Rate (TFR)

Total number of children a woman would have by the end of her reproductive period if she experienced current fertility rates.

Maternal Mortality Ratio (MMR)

Annual number of maternal deaths per 100,000 live births

Antenatal Care Coverage

Percentage of women attended at least once during pregnancy by skilled health personnel (excluding trained or untrained traditional birth attendants).

Percent of Births Attended by Skilled Health Personnel

Percentage of births attended by skilled health personnel (excluding trained or untrained traditional birth attendants).

Availability of Basic Essential Obstetric Care

Number of facilities with functioning basic essential obstetric care per 500,000 population

Availability of Comprehensive Essential Obstetric Care

Number of facilities with functioning comprehensive essential obstetric care per 500,000 population

Perinatal Mortality Rate (PMR)

Number of perinatal deaths per 1,000 total births

Low Birth Weight Prevalence

Percentage of live births weighing less than 2,500g

Positive Syphilis Serology Prevalence in Pregnant Women

Percentage of pregnant women attending antenatal clinics, whose blood has been screened for syphilis, and tested positive.

Prevalence of Anemia in Women

Percentage of women of reproductive age (15-49), screened for hemoglobin levels, with levels 110g/l for pregnant, and 120g/l for non-pregnant.

Percent of Obstetric and Gynecological Admissions Owing to Abortion

Percentage of all cases admitted to service delivery points for in-patient obstetric and gynecological services, which are due to abortion (spontaneous and induced).

Prevalence of Infertility in Women

Percentage of women of reproductive age (15-49) at risk of pregnancy who report trying to conceive for two or more years.

HIV Prevalence among Pregnant Women

Percentage of pregnant women attending antenatal clinics and tested positive for HIV.

Percentage of respondents correctly identifying all three major ways of preventing sexual transmission of HIV and who reject mis-conceptions about transmission or prevention.

What is Maternal Death?

Death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of duration or location of pregnancy
From causes related, or aggravated by pregnancy/its management.
Global rate is 211 maternal deaths per 100,000 births in 2017
Almost 800 women died in 2020 from preventable causes related to pregnancy and childbirth.
95% of maternal deaths occurred in low and lower-middle income countries in 2020

Why Do Women Die?

Primarily due to complications during and after pregnancy/childbirth.
Major complications (accounting for nearly 75% of maternal deaths) include severe bleeding, infections, high blood pressure during pregnancy (preeclampsia/eclampsia), complications from delivery.
Unsafe abortion

What is Maternal Mortality? - Four Measures

Maternal mortality ratio: The ratio of maternal deaths during a given time period per 100,000 live births. - Measures obstetric risk.
Maternal mortality rate: The number of maternal deaths in a population divided by the number of women of reproductive age.
Lifetime risk of maternal death: A calculated prediction of a woman's risk of death after each consecutive pregnancy.
Proportion of maternal deaths among deaths of women of reproductive age: The number of maternal deaths in a given time period divided by the total deaths among women aged 15-49 years.

Maternal Mortality Ratio (2015)

The number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births.
Target is to reduce maternal deaths to less than 70 per 100,000 live births globally, and less than 140 per 100,000 live births per country.

Perinatal Mortality Rate

Perinatal mortality refers to the death of a fetus or neonate
The World Health Organization defines perinatal mortality as the number of stillbirths and deaths in the first week of life per 1,000 total births (from conception to 7 days after birth)
In developed countries the perinatal mortality is below 10
In Turkey it was 9.1 in 2019

Definitions

Live birth: Complete expulsion or extraction from the mother of a product of conception that breathes, pulses, or shows movement of voluntary muscles, regardless of duration of pregnancy, cord cutting, or placental attachment.
Fetal death: Death before complete expulsion or extraction that isn't followed by respiration or movement.
Duration of gestation: Measured from the first day of the last normal menstrual period in completed days/weeks.

Brief Information

Low birth weight: less than 2500g at birth
Very low birth weight: less than 1500g
Prenatal period: The process from embryo formation to birth
Germinal stage
Embryonic stage
Fetal stage
Perinatal period: The period immediately before and after birth
Postnatal period: The first six weeks after birth.

Prenatal Stage

Germinal stage: Starts with fertilization of egg by sperm
Embryonic stage: Organs start to be developed
Fetal stage: Body systems & structures are established

Perinatal Stage

Definition: The period immediately before and after birth
Time frame: 22 weeks of gestation to 7 days after birth
Critical period: Crucial for the mother's and baby's health, focusing on labor, delivery, and early neonatal period.

Postnatal Stage

Definition: The period immediately after birth to 6 weeks postpartum
Includes support of the mother and baby

Importance of Gynecology and Obstetrics Nursing

Equip nurses with anatomy and physiology of reproductive organs
Understanding of obstetric drugs and their effects/complications
Skills in antenatal care and abnormality detection
High-risk case selection, record keeping, safe delivery
Post-partum care, identifying complications, and breastfeeding support
Supporting mothers with reproductive health issues

How to Prevent Obstetric Complications

Comprehensive antenatal care is crucial
Early detection of high-risk pregnancies
Ensuring quality hospital care
Environmental hygiene is important
Reducing the incidence of induced abortions by promoting family planning

Obstetric and Gynecological Nursing

Specializes in women's reproductive health from puberty through menopause
Provides care during critical periods (pregnancy, labor, and postpartum recovery)
Encompasses general reproductive health, including exams, diagnostic procedures, education on menstrual health, contraception, and sexually transmitted infections

Managing High-Risk Pregnancies

Nurses closely monitor high-risk pregnancies (gestational diabetes, hypertension, previous pregnancy complications)
Coordinate with doctors, educate mothers on condition management, and perform frequent check-ups

Hypertension (High Blood Pressure in Pregnancy)

Definition: Blood pressure above 140/90 mmHg during pregnancy
Risk factors: Obesity, previous high blood pressure, diabetes, or family history of hypertension
Monitoring: Regular blood pressure checks and urine tests to monitor protein levels
Complications: Leads to preeclampsia if left untreated

Preeclampsia

Definition: High blood pressure and protein in the urine after 20 weeks of pregnancy
Symptoms: Severe headaches, swelling (especially in hands and feet), blurred vision, and sudden weight gain
Risks: Can lead to preterm birth, organ damage, or placental abruption.

Eclampsia

Definition: A severe complication of preeclampsia, leading to seizures or coma
Symptoms: Seizures, loss of consciousness, severe headaches
Risks: Life-threatening for both the mother and the baby

Family Planning and Prenatal Guidance

Nurses offer critical advice on family planning throughout the prenatal period.
Help families with informed decisions about birth spacing, contraception options, and postpartum expectations
Educate mothers on waiting periods after childbirth

Breastfeeding and Nutrition Education

Nurses provide tailored advice to ensure mothers are eating a balanced diet to support both their health and the baby's growth.
Focus on key nutrients: protein, iron, calcium, folic acid, and recommends foods rich in these nutrients.

Breastfeeding Recommendation

Start breastfeeding within the first hour after birth
Exclusive breastfeeding for first 6 months without additives.
Feed on demand
Ensure correct latch and alternate breasts during each session

Emotional Support

Nurses provide support during pregnancy, which can be emotional and difficult
Coping with anxiety, stress, or depression.
Identifying signs of prenatal depression and offering referrals for counseling or mental health support.

7. Emergencies

Nurses must be able to detect early signs of pregnancy-related complications, such as preterm labor.
Heavy bleeding, and/or fetal distress. Should quickly respond and provide immediate care, and arrange for necessary medical attention.

The Role of Nurses in Postpartum Care

Comprehensive care during this time is important for the mother and newborn
Monitor mother's recovery from childbirth, ensure baby's health, and guide family in adjusting to newborn
Educate mothers on proper wound care (especially C-sections) and management of post-partum pain
Monitoring for complications: Infections, excessive bleeding, or deep vein thrombosis

Postpartum Depression

Depression that occurs after childbirth, typically within the first few weeks but can develop up to a year postpartum
Symptoms: Persistent sadness, anxiety, fatigue, lack of interest in the baby, difficulty bonding with the baby, irritability, and changes in sleep or appetite

The Role of Nurses in Infertility and Assisted Reproductive Techniques

Nurses educate couples about infertility treatments, support them during the process, and provide emotional support.

Multiple Choice Questions - 1

What is the main cause of maternal mortality?
- A) Complications from delivery
What does Total Fertility Rate (TFR) indicate?
- B) The average number of children a woman will have during her reproductive years
When is the perinatal stage?
- D) From 22 weeks of gestation to 7 days after birth
What is the main risk of untreated hypertension during pregnancy?
- A) Preeclampsia
When is the Double Test performed?
- C) Between 11-14 weeks of pregnancy
What is a typical symptom of preeclampsia? - D) High blood pressure and protein in the urine
What does the Triple Test screen for?
- A) Down syndrome, Trisomy 18, and neural tube defects
What is the focus during the postnatal stage?
- B) Monitoring the mother's recovery and newborn health.
What is a common symptom of postpartum depression?
- C) Persistent sadness and lack of interest in the baby.
What is the recommended duration for exclusive breastfeeding?
- A) The first 6 months
What does Nuchal Translucency (NT) screening measure?
- C) The thickness of fluid at the back of the baby's neck.
When is the Triple Test typically performed?
- B) Between 16-18 weeks of pregnancy.
Which of the following is a risk factor for preeclampsia?
- C) High blood pressure.
What is a main focus during antenatal care?
- C) Monitoring fetal development and maternal health.
Multiple Choice Questions - 2
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