Determinants of maternal near miss at tertiary care hospital: a retrospective study

Shweta Kumari; Rashmi Prasad; Kanchan Dalmia

doi:10.18203/2320-1770.ijrcog20232942

Authors

Shweta Kumari Department of Obstetrics and Gynecology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
Rashmi Prasad Department of Obstetrics and Gynecology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India
Kanchan Dalmia Department of Obstetrics and Gynecology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20232942

Keywords:

Maternal near miss, Hemorrhage, Risk factors for MNM

Abstract

Background: A woman who experienced a severe complication and she nearly died, but she survived the severe health condition during pregnancy, childbirth or postpartum is considered as maternal near miss. The investigation of near miss cases not only gives the superior information about disease burden but also the quality of care received by the mother.

Methods: A hospital based retrospective study carried out on 120 pregnant women seeking treatment at the hospital were included in the study. Mothers who met the criteria for maternal near miss were identified by review of records.

Results: In the present study, out of the 120 near miss cases studied, 60 (50.0%) cases belonged to the age group 18-24 years which forms about half of the population studied. 38 (31.66%) cases belonged to 25-29 years group, 15 (12.50%) cases in 30-34 years group and 7 (5.83%) cases in 35 years and above age group. Also, 104 (86.66%) cases from rural area whereas only 16 (13.33%) cases came from urban area.

Conclusions: In this study, the most common causes of maternal near misses were haemorrhage (48.33%), hypertension (20%), severe anaemia (13.33%), sepsis (10%), cardiac dysfunction (3.33%), renal dysfunction (0.83%), respiratory dysfunction (0.83%) and liver dysfunction (0.83%).

Metrics

Metrics Loading ...

References

Nielsen HS, Eggebo TM. Millenium development goal 5- an obstetric challenge. Acta Obstetricia et Gynecologica Scandinavia. 2012;91(9):1007-8.

Stones W, Lim W, Al-Azzawi F, Kelly M. An investigation of maternal morbidity with identification of life threatening “near miss” episodes. Health Trends. 1991;23(1):13-5.

Sivalingum N, Looi KW. Clinical experiences with management of near miss cases in Obstet Med J Malaysia. 1999;54(4):496-503.

World Health Organization. Evaluating the quality of care for severe pregnancy complications: The WHO near miss approach for maternal health. 2011. Available at: https://www.who.int/publications/i/ item/9789241502221. Accessed on 12 June 2023.

Bansal M, Lagoo J, Pujari K. Study of near miss cases in obstetrics and maternal mortality in Bastar, Chhattisgarh, India. Int J Repro Contracept Obstet Gynaecol. 2016;5(3):620-3.

Behera R, Behera AA. Study on maternal mortality and near miss cases. J. Evid Based Med Healthc. 2017;4(93):5720-4.

Kamal S, Roy P Singh S, Minz J. A study on maternal near cases at tertiary medical college, Jharkhand, India. Int J Reprod Contracept Obstet Gynaecol. 2017;6:2375-80.

Sahijwani DV, Desai A, Kansara V. Analysis of near miss cases as a reflection of emergency obstetric services and need of obstetric ICCU. J South Asian Feder Obst Gynae. 2013;5(3):99-101.

Sharma P, Jaiswal A. A critical analysis of determinants of maternal near cases at rural tertiary health centre. Global J Res Analy. 2017;6(2):2277-8160.

Shrestha J, Shrestha R, Tuladhar R, Gurung S, Shrestha A. Maternal near miss in a tertiary care teaching hospital. Am J Pub Health Res. 2015;3(5):17-22.

Reena RP, Radha KR. Factors associated with maternal near miss: a study from Kerala. Indian J Pub Health. 2018;62:58-60.

Chaudhuri S, Nath S. Life-threatening complications in pregnancy in a teaching hospital in Kolkata, India. J Obstet Gynecol India. 2019;69:115-22.

Alluvala SA, Aziz N, Tumkur A, Boorugu HK. Oneyear follow-up of women with severe acute maternal morbidity (SAMM): A cohort study. J Obstet Gynecol India. 2019;69:211-7.

Pandit R, Jain V, Bagga R, Sikka P, Jain K. Applicability of WHO Maternal Severity Score (MSS) and Maternal Severity Index (MSI) model to predict the maternal outcome in near miss obstetric patients: A prospective observational study. Arch Gynecol Obstet. 2019;300:49-57.

Ps R, Verma S, Rai L, Kumar P, Pai MV, Shetty J. “Near miss” obstetric events and maternal deaths in a tertiary care hospital: An audit. J Pregnancy. 2013;393758.