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B Subha Sri , Renu Khanna CommonHealth Baroda, March 2012. MATERNAL DEATHS AND THEIR MEASUREMENTS. What is a maternal death?. A maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy,
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B Subha Sri, RenuKhanna CommonHealth Baroda, March 2012 MATERNAL DEATHS AND THEIR MEASUREMENTS
What is a maternal death? • A maternal death is the death of a woman • while pregnant or within 42 days of termination of pregnancy, • irrespective of the duration and the site of the pregnancy, • from any cause related to or aggravated by the pregnancy or its management, • but not from accidental or incidental causes.
Pregnancy related death • Pregnancy-related death is defined as the death of a woman • while pregnant or within 42 days of termination of pregnancy, • irrespective of the cause of death. • Fatalities during but unrelated to a pregnancy are termed accidental, incidental, or nonobstetrical maternal deaths.
Direct Maternal Death and Indirect Maternal Death • Direct Maternal Death - result of a complication of the pregnancy, delivery, or management of the two • Indirect Maternal Death - is a pregnancy-related death in a patient with a preexisting or newly developed health problem unrelated to pregnancy
Perinatal deaths • Stillbirth - deadborn fetus • either before onset of labour (antepartum death) or • because of pregnancy complications or maternal diseases • no special reason • during labour (intrapartum death) • Complications arising during birth Where women receive good care during childbirth, intrapartum deaths represent less than 10% of stillbirths due to unexpected severe complications.
Perinatal deaths • Perinatal death = Stillbirths + Deaths of newborn in the first week of life • Perinatal mortality is an important indicator of maternal care and of maternal health and nutrition
Measurement of maternal deaths • Maternal mortality ratio (MMR) • Number of maternal deaths during a given time period per 100 000 live births during the same time-period.
Maternal Mortality Rate • Number of maternal deaths per 1000 women in reproductive age group (15 to 44 years) in the population
Life time risk of maternal death • Accounts for number of pregnancies and risk • In sub Saharan Africa lifetime risk of maternal death is 1 in 16, while in developed countries it is 1 in 28,000
Difficulties in measurement • Maternal death, from an epidemiological perspective, is a relatively rare event • Comprehensive registration of deaths and their causes, by and large, does not exist • Cause of death is many times difficult to attribute • Census, surveys and models have to be used to estimate levels of maternal mortality