Podcast
Questions and Answers
What is the definition of maternal mortality according to the World Health Organization (WHO)?
What is the definition of maternal mortality according to the World Health Organization (WHO)?
The death of a woman while she is pregnant or within 42 days of the termination of the pregnancy from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.
What are the two main categories of maternal deaths?
What are the two main categories of maternal deaths?
Direct deaths and Indirect deaths
Direct obstetric complications account for 75% of maternal deaths.
Direct obstetric complications account for 75% of maternal deaths.
True (A)
What is the maternal mortality ratio (MMR) and how is it calculated?
What is the maternal mortality ratio (MMR) and how is it calculated?
What is the maternal mortality rate (MMRate) and what does it reflect?
What is the maternal mortality rate (MMRate) and what does it reflect?
Maternal mortality worldwide has decreased by almost 50% between 1990 and 2013.
Maternal mortality worldwide has decreased by almost 50% between 1990 and 2013.
The majority of maternal deaths occur in Europe and North America.
The majority of maternal deaths occur in Europe and North America.
What is one of the main reasons why women in remote areas struggle to access adequate healthcare?
What is one of the main reasons why women in remote areas struggle to access adequate healthcare?
What are the recommended number of antenatal care visits for pregnant women?
What are the recommended number of antenatal care visits for pregnant women?
Which of the following factors prevent women from accessing or seeking care during pregnancy and childbirth?
Which of the following factors prevent women from accessing or seeking care during pregnancy and childbirth?
Which of the following interventions can help reduce maternal mortality?
Which of the following interventions can help reduce maternal mortality?
Provide an example of a maternal factor influencing pregnancy outcome.
Provide an example of a maternal factor influencing pregnancy outcome.
Provide an example of a pregnancy-related factor influencing pregnancy outcome.
Provide an example of a pregnancy-related factor influencing pregnancy outcome.
Provide an example of a labor-related factor influencing pregnancy outcome.
Provide an example of a labor-related factor influencing pregnancy outcome.
Provide an example of a socioeconomic circumstance influencing pregnancy outcome.
Provide an example of a socioeconomic circumstance influencing pregnancy outcome.
On average, how long can a woman survive after the onset of postpartum hemorrhage if left untreated?
On average, how long can a woman survive after the onset of postpartum hemorrhage if left untreated?
On average, how long can a woman survive after the onset of obstructed labor if left untreated?
On average, how long can a woman survive after the onset of obstructed labor if left untreated?
Which of the following is NOT a key function of Emergency Obstetric Care (EmOC)?
Which of the following is NOT a key function of Emergency Obstetric Care (EmOC)?
What are the two main types of EmOC?
What are the two main types of EmOC?
What is one way to improve standards of health facilities in order to reduce maternal mortality?
What is one way to improve standards of health facilities in order to reduce maternal mortality?
What is one way to improve community education to reduce maternal mortality?
What is one way to improve community education to reduce maternal mortality?
Flashcards
Maternal Death
Maternal Death
A woman's death while pregnant or within 42 days after pregnancy ends, caused or made worse by pregnancy or its management, excluding accidents or unrelated causes.
Direct Maternal Death
Direct Maternal Death
Deaths directly caused by complications of pregnancy, labor, or the postpartum period, including interventions or incorrect treatment.
Indirect Maternal Death
Indirect Maternal Death
Deaths resulting from pre-existing conditions, or diseases aggravated by pregnancy, but not directly related to obstetric causes.
Late Maternal Death
Late Maternal Death
Deaths occurring between 42 days and a year after abortion, miscarriage, or delivery, due to direct or indirect maternal causes.
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Coincidental Maternal Death
Coincidental Maternal Death
Unrelated deaths happening to occur during pregnancy or the postpartum period, such as car accidents.
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Maternal Mortality Ratio (MMR)
Maternal Mortality Ratio (MMR)
The number of maternal deaths during a specific time period per 100,000 live births during the same period.
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Maternal Mortality Rate (MMRate)
Maternal Mortality Rate (MMRate)
The number of maternal deaths (direct and indirect) within a given period per 100,000 women of reproductive age during the same time period.
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Factors Influencing Pregnancy Outcome
Factors Influencing Pregnancy Outcome
Factors that can increase the risk of a negative outcome during pregnancy, such as age, parity, health status, and infection.
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Emergency Obstetric Care (EmOC)
Emergency Obstetric Care (EmOC)
A set of essential medical interventions designed to handle life-threatening complications during childbirth and pregnancy.
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Key Functions of EmOC
Key Functions of EmOC
A collection of essential medical interventions used during delivery. Includes antibiotics, oxytocin, anticonvulsants, and surgical procedures.
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Maternal Mortality Rate
Maternal Mortality Rate
The measure of how many maternal deaths occur each year per 100,000 live births.
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Maternal Deaths
Maternal Deaths
The number of deaths from pregnancy-related causes that happen each year.
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Direct Obstetric Complications
Direct Obstetric Complications
A type of maternal death that occurs from complications during labor and delivery.
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Indirect Obstetric Complications
Indirect Obstetric Complications
Deaths resulting from pre-existing conditions, illnesses, or health issues that are worsened by pregnancy.
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Maternal Mortality Risk
Maternal Mortality Risk
The risk of a woman dying during pregnancy or childbirth, measured by the MMR.
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Maternal Health Care
Maternal Health Care
The provision of care for women during pregnancy and childbirth to prevent complications and ensure a safe delivery.
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Prevention of Maternal Deaths
Prevention of Maternal Deaths
Improving access to healthcare, training healthcare professionals, and educating communities are key strategies to reduce maternal deaths.
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Parity
Parity
Having more children can increase the risk of complications during pregnancy.
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Malpresentation
Malpresentation
A condition where the baby is positioned abnormally in the womb, making delivery difficult.
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Spacing
Spacing
Lack of adequate space between pregnancies can increase health risks for both the mother and the baby.
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Disproportion
Disproportion
A type of complication during labor that occurs when the baby's head is too large to fit through the mother's pelvis.
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Prolapse of Cord
Prolapse of Cord
A serious condition that occurs when the umbilical cord comes out before the baby.
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Maternal Immune System Attack
Maternal Immune System Attack
A condition where a mother's immune system attacks her own baby.
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Medical Problems
Medical Problems
Conditions that can make pregnancy more difficult or dangerous, such as diabetes, heart disease, and kidney problems.
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Smoking
Smoking
Smoking during pregnancy can harm both the mother and the baby.
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Neonatal Infection
Neonatal Infection
Infection acquired during childbirth from the mother's birth canal.
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Labor Duration
Labor Duration
The length of time a woman is in labor.
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Emergency Obstetric Condition
Emergency Obstetric Condition
An emergency condition that needs immediate medical attention.
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Medical Interventions
Medical Interventions
The use of medications or procedures during labor and delivery.
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Oxytocin
Oxytocin
A type of medication used to stimulate contractions during labor.
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Anticonvulsants
Anticonvulsants
A type of medication used to prevent seizures.
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Manual Removal of Placenta
Manual Removal of Placenta
A procedure used to remove the placenta if it is not delivered naturally.
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Removal of Retained Products
Removal of Retained Products
A procedure to remove any remaining tissue after delivery.
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Maternal Mortality
- Maternal mortality is the death of a woman while pregnant or within 42 days of pregnancy termination, caused by or aggravated by pregnancy or its management, but not accidental or incidental causes. (WHO)
- WHO estimates more than 500,000 maternal deaths annually.
- More than one woman dies every minute from pregnancy-related causes.
Types of Maternal Deaths
- Direct deaths: Result from obstetric complications of pregnancy, labor, or puerperium (e.g. hemorrhage, unsafe abortion, eclampsia).
- Indirect deaths: Result from pre-existing diseases aggravated by pregnancy (e.g. cardiac lesion).
- Late deaths: Occur between 42 days and one year after abortion, miscarriage, or delivery, due to direct or indirect maternal causes.
- Coincidental deaths: Result from unrelated causes during pregnancy or puerperium (e.g. car accidents).
Direct Obstetric Complications
- Hemorrhage (21%)
- Unsafe Abortion (14%)
- Eclampsia (13%)
- Obstructed Labor (8%)
- Infection (8%)
- Other causes (11%)
- Account for 75% of maternal deaths.
Indirect Obstetric Complications
- Pre-existing conditions (e.g. malaria, anemia, hepatitis, HIV/AIDS)
- Account for 25% of maternal deaths.
Maternal Mortality Ratio (MMR)
- MMR is the number of maternal deaths during a given time period per 100,000 live births during the same period.
- MMR is a measure of healthcare system quality
Maternal Mortality Rate (MMRate)
- MMRate is the number of maternal deaths (direct and indirect) per 100,000 women of reproductive age during a given period.
- MMRate reflects the risk to women during pregnancy and childbirth.
- Factors influencing MMRate include socioeconomic conditions, nutrition, sanitation, and maternal healthcare.
WHO Report 2014
- Maternal mortality worldwide decreased by nearly 50% between 1990 and 2013
- The Millennium Development Goal 5 aimed for a 75% reduction in maternal mortality by 2015 compared to 1990 levels.
- 99% of maternal deaths currently occur in Africa, Asia, and Latin America.
Access to Care: Why Do Women Not Get Necessary Care?
- Poor women in remote areas are least likely to receive adequate care, particularly in regions with few skilled healthcare workers.
- High-income countries provide nearly all women with at least four antenatal care visits, skilled birth attendance, and postpartum care.
- In low-income countries, only a third of pregnant women have the recommended antenatal visits.
Factors Preventing Care Seeking
- Poverty
- Distance
- Lack of information
- Inadequate services
- Cultural practices
Factors Reducing MMR
- Access to basic medical care during pregnancy, childbirth, and postpartum periods
- Skilled birth attendance
- High-quality postpartum care
Factors Influencing Pregnancy Outcome
- Maternal Factors:
- Age (under 16 or over 40)
- Parity (number of previous pregnancies)
- Pregnancy spacing (less than 2 years)
- Health status, body build, height
- Nutritional deficiencies
- Infections (e.g. syphilis, toxoplasmosis, rubella, CMV)
- Medical conditions (e.g., diabetes, hypertension, heart disease, kidney disease)
- Smoking
- Pregnancy-Related Factors: All risk factors associated with pregnancy and obstetric history.
- Labor-Related Factors:
- Prolonged labor
- Malpresentation, disproportion, prolapse of cord, trauma
- Chemical factors (analgesics, anesthetics, hypoxia, cerebral damage)
- Neonatal infections (acquired from infected birth canals)
- Fetal Factors: Genetic inheritance problems
- Socioeconomic Circumstances: low income, poor living conditions, illiteracy, faulty traditions, lack of medical care
Emergency Obstetric Care (EmOC) Key Functions
- Antibiotics (IV or IM)
- Oxytocic drugs
- Anticonvulsants
- Manual removal of placenta
- Removal of retained products
- Assisted vaginal delivery
- Surgery (Cesarean section)
- Blood transfusion
- Comprehensive (1-8) vs. basic (1-6) EmOC
Prevention of Maternal Deaths
- Establish maternal mortality committees to improve health facility standards.
- Proper training for healthcare professionals (obstetricians, GPs, midwives, TBAs).
- Educate communities to encourage mothers to attend antenatal care (ANC).
- Identify and manage high-risk groups.
- Conduct research.
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