Maternal and perinatal mortality
Maternal death is death of a women while pregnant or within 42 days of delivery,miscarriage,termination of pregnancy or ectopic, from any cause related to or aggravated by pregnancy or its management but not from accidental or incidental causes.Direct death
The result of complication of pregnancy, delivery or puerperium , from intervention , incorrect treatment, or from chain of events resulting from any of the above.
Late neonatal death:
Death from age of 7 days to 27 completed days of life.
Postneonatal death:
Death of age of 28 days and over but under one year.
Infant death:
Death at age under one year .rate of infant and neonatal deaths are expressed as rates per 1000 live births.
In England, the still birth rate is 5.4 per 1000 birth
The neonatal death rate is 4.1 per 1000 birth
Perinatal death rateis 8.7 per 1000 total births.
Causes of perinatal mortality:
1)prematurity (50%).
2)congenital malformation(16%).
3)antepartum fetal death.
4)birth asphyxia
5)infection
b)indirect death:
1)cardiac disease
2)neurological diseases
3)respiratory diseases
4)psychiatric diseases
Perinatal mortality
Stillbirth:
any fetus born with no signs of life after 23 weeks+ 6 days.
Early neonatal death:
Death from birth to completed 6 days of life.
Perinatal death:
All stillbirths plus early neonal deaths.
Perinatal mortality death:
Is used to define the number of perinatal deaths per 1000 live births and stillbirths.
There is decline in the death rate because of
1)antibiotic
2)availability of blood and blood products
3)use of oxytocic drugs, active management of third stage.
4)better training of medical staff.
5)family planning, spacing, improved health service in general and specially antenatal care.
6)legalization of abortion in some countries.
Causes of maternal mortality
Direct deaths
1)thrombosis and thromboembolic diseases
2)hypertensive diseases
3)amniotic fluid embolism
4)hemorrhage.
5)infections and sepsis.
6)genital tract trauma
7)early pregnancy deaths( ectopic, miscarriage)
In developing world hemorrhage, sepsis and hypertensive diseases are likely to be at the top.
Indirect death:
Pregnancy related death in a patient with pre existing or newly developedhealth problem that was not the result of direct obstetrical cause but which was aggravated by the physiological changes of pregnancy.
Late death: