Dr. Huda Anan Habib
Every year 529,000 women die as a direct result of being pregnant-99% of them in the developing world. In turn, these deaths contribute to the deaths of at least 1.5 million infants in the first week of life and 1.4 million still babies. The tragedy is that almost all of these deaths could be prevented through the provision of some of the most basic health care measures.MMR reflect the risk to women during pregnancy & child birth . it is influenced by : General socioeconomic condition Nutrition Sanitation Maternal health care
Millennium Development Goal 5 calls for an improvement in maternal health and reduction in maternal mortality by 75% by 2015 from 1990 levels.
To improve maternal health, barriers that limit access to quality maternal health services must be identified and addressed at all levels of the health system.
So factors that prevent women from receiving or seeking care during pregnancy and childbirth are: poverty distance lack of information inadequate services cultural practices.
Most of maternal deaths could be prevented if women have: Access to basic medical care during pregnancy , childbirth & postpartum period . Skilled attendance of birth . most maternal deaths occur either during or shortly after delivery High quality of postpartum care : health care immediately after a critical period of labor & delivery is a single most important intervention for preventing maternal mortality & newborn morbidity & mortality
Safe motherhood project aims to reduce MMR & perinatal death through providing:Care by skilled health personnel before, during and after childbirth.Emergency care for life – threatening obstetric complication .Service to prevent and manage the complications of unsafe abortion .Family planning to enable women to plane their pregnancies and prevent unwanted pregnancies.Health education and services for adolescents.Community education for women , their families and decision makers.
full term infant : infant born between 37 -42 week of gestation calculated from the LMP preterm birth ( premature birth ) :an infant born before the end of the 37th week of pregnancy, calculated from the first day of the LMP . Low birth weight (LBW) : is a live borne baby weight less than 2500grams ( 5 pounds & 8 ounces ) . Very low birth weight : is a live borne baby weight less than 1500 grams ( 3 pounds & 5 ounces ).
Small for date babies : an infant borne with birth weight under the 10th percentile line or 2 SD below the mean body weight for gestational age ( it is a sign of IUGR). Large for date babies : an infant borne above the 90th percentile line or 2 SD above the mean body weight for certain gestational age .
Live birth : any baby that shows signs of life irrespective of gestation age .Still birth : a baby born with no sign of life ( dead ) at ≥ 24 weeks gestational age.Abortion ( miscarriage) : loss of products of conception occurring any time between implantation & 24 weeks gestational age .
Perinatal death : all stillbirth plus deaths in the first week after birth. Perinatal mortality rate (PMR) : the number of stillbirth and early neonatal deaths per 1000 live births & stillbirths. Neonatal death: death of infant less than a 28 days of life.
Early neonatal death : death in the first week after birth Late neonatal death : death of a neonate from age 7 days to 27 days completed days of life . Post- neonatal death : death of a baby at age 28 days and over, but under one year . Infant death : death at age under one year of a baby born alive.
3.labour related factors : mechanical factors: prolonged labour , malpresentation , disproportion , prolapse of cord , and trauma . chemical factors: analgesics & anesthetics given to pregnant women , or ketosis that may cause hypoxia , cerebral damage . neonatal infection : acquired from birth canal of infected pregnant women during child birth ( along process of normal vaginal delivery ) e.g HIV , ophthalmia neonatorium
4.fetal factors : that result from genetic ( inheritance problems) 5.Socioeconomic circumstances : may indirectly have adverse effect on outcome low income & poor living condition illiteracy or low education . faulty tradition . lack of medical care .