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Flashcards in MMBRACE 2018 Deck (35)
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1

How many maternal deaths were reported in 3014_2016

9.8 per 100 000
During or end of pregnancy
or 6 weeks after childbirth

2

Preterm deaths_ how many

About 70% of all extended
perinatal deaths occur before term and
nearly 40% occur extremely preterm at
less than 28 weeks’ gestation

3

What is the rate of congenital anomslies in prrterm deaths

congenital anomalies at 1 in 6 of all
extended perinatal deaths
for some Trusts and
Health Boards, particularly the tertiary
centres with neonatal surgical provision,
and in Northern Ireland where termination
of pregnancy is only legal in exceptional
circumstances, the proportion of their
deaths associated with congenital
anomalies will be much higher than 1 in6

4

What is the death rate reduction in twins

halving in the rate of
stillbirths in twins and although the
reduction in neonatal deaths is smaller at
30% both represent a statistically
significant decrease

5

What is the PMRT

national Perinatal Mortality
Review Tool (PMRT) earlier this year is
designed to support high quality,
multidisciplinary local review of the care
provided at all stages of the maternity and
neonatal pathway on the basis of “review
once, review well”.

6

Late fetal loss

delivered between 22+0 and 23+6
weeks gestational age showing no
signs of life, irrespective of when the
death occurred.

7

Stillbirth

delivered at or after 24+0 weeks
gestational age showing no signs of
life, irrespective of when the death
occurred.

8

Intrapartum stillbirth

A baby delivered at
or after 24+0 weeks gestational age
showing no signs of
life and known to have been alive at the
onset of care in labour.

9

Neonatal death

liveborn baby (born
at 20+0 weeks gestational age or later,
or with a
birthweight of 400g or more where an
accurate estimate of gestation is not
available), who died before 28 completed
days after birth.

10

Early neonatal death

A liveborn baby
(born at 20+0 weeks gestational age
or later, or with a weight of 400g or more

11

Perinatal death

A stillbirth or
early neonatal death.

12

Extended perinatal death

A stillbirth or
neonatal death.

13

Any change in extended perinatal mortality

No
There has been little change in the
rate of extended perinatal mortality in the
UK in 2016: 5.64 per
1,000 total births for babies born at 24+0
weeks gestational age or later compared
with 5.61 in 2015. However this
represents an overall fall from 6.04 deaths
per 1,000 total births in 2013.

14

Still birth rate in uk

The stillbirth rate for the UK in 2016
has remained fairly static at 3.93 per 1,
000 total birth

15

neonatal mortality

neonatal mortality in the
UK has shown a slow but steady decline
over the period 2013
to 2016 from 1.84 to 1.72 deaths per 1,
000 live births.

16

Variation in neonstal mortality rated

the
reported neonatal mortality rates show a
wide variation, with rates of between 1.
78 and 3.52 per 1,000 live births in those
with level 3 Neonatal Intensive Care
Units (NICUs) and surgical provision and
significantly lower rates in the small units
delivering less than 2,000 births per
annum (0.97 to 1.18).

17

What are the stabilised & adjusted
extended perinatal mortality rates

for
commissioning organisations ranging from
5.32 to 6.29 deaths per 1,000 total birth

18

Consent for post mortems

small increase in
the rate of consent for post-mortem for
stillbirth from 47.2% to
49.4% (2014 to 2016)

19

Neonatal deaths

decrease for neonatal deaths from 29.1%
to 28.6%

20

perceng of placental histology

which placental histology is carried out: 89.
9% in 2016 compared to 88.8% in 2015.

21

Reduction in twin deaths

2014 to
2016, reducing from 2.8 (95% CI, 2.47 to
3.17) to 1.6 (95% CI, 1.36 to 1.88) for
stillbirths and from 4.91 (95% CI, 4.20 to
5.73) to 3.33 (95% CI, 2.80 to 3.98) for
neonatal deaths.

22

Key recommendation

1need to be focused on
reducing stillbirths and continuing the
decreased mortality rates

23

key recommendation 2

facilitate the close
working between MBRRACE-UK and the
Perinatal Mortality Review
Tool (PMRT), within Trusts and Health
Boards all stillbirths and neonatal deaths
should be notified to MBRRACE-UK via
the joint web-based system as soon as
possible following the death.

24

Key recommendation 3

Commissioning organisations should
review both their crude and their stabilised
& adjusted mortality
rates to facilitate the identification of
high risk populations and to target
interventions for known inequalities.

25

Key recommendation 4

Trusts and Health Boards with a
stabilised & adjusted stillbirth, neonatal
mortality or extended

26

KR5

Irrespective of where they fall in the
spectrum of national performance all
Trusts and Health Boards
should use the national PMRT to review
all their stillbirths and neonatal deaths.

27

KR6

Trusts and Health Boards should
ensure that the data provided to
MBRRACE-UK is of the highest
quality. T

28

KR7

National health forum

29

KR8

Public health initiatives should
continue to be developed to reduce the
impact of known risk factors
for stillbirth and neonatal death; for
example, smoking and obesity

30

KR9

Trust and Health Board Perinatal
Review groups should focus on the quality
of cause of death coding.