Maternal near miss: a retrospective study in a tertiary care hospital at South India
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20240784Keywords:
MNM, SAMM, NMA, Morbidity, WHO criteriaAbstract
Background: A maternal near miss (MNM) case is defined as a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy. MNM situations tend to mirror the causes of maternal death. Hence, review of these cases has been found to help in the assessment of maternal health services. These cases are called as MNM or severe acute maternal morbidity (SAMM) and auditing these cases is called near miss audit (NMA).
Methods: A retrospective study of 201 MNM cases over a period of 12 months from January 2023- December 2023. Demographic data were collected from MNM review form and records. Data studied and analyzed.
Results: There were 11,340 deliveries and 11,126 live births during the study period out of which 201 MNM cases were studied. Haemorrhage followed by anemia was the most common cause of near miss events. The most common age group affected in the near miss cases in the present study was 20 to 35 years (80%). Majority of the cases were referred from the nearby PHCs and government hospitals.
Conclusions: Most maternal deaths are preventable by optimal utilization of existing MCH facilities, identifying the bottleneck in health delivery system, early identification of high-risk pregnancy and therein timely referral to tertiary care centre.
Metrics
References
World Health Organization. Evaluating the quality of care for severe pregnancy complications - the WHO near- miss approach for maternal health. Geneva: World Health Organization. 2011.
Say L, Pattison RC, Gulmezoglu AM. WHO systematic review of maternal morbidity and mortality: the prevalence of severe acute maternal morbidity (near miss). Reprod Health. 2004;1:3.
World Health Organization. The WHO Near-Miss Approach for Maternal Health. World Health Organization; 2011. Available at: http://www.who.int/reproductivehealth/0Ahttp://apps.who.int/iris/bitstream/10665/44692/1/9789241502221_eng.pdf. Accessed on 29 January 2024.
Gedefaw M, Gebrehana H, Gizac$hew A, Taddess F. Assessment of maternal near miss at debre markos referral hospital, Northwest Ethiopia: five years’ experience. Open J Epidemiol. 2014;4(4):199-207.
Roösẗ M, Altamirano VC, Liljestrand J, Essén B. Priorities in emergency obstetric care in Bolivia-maternal mortality and near-miss morbidity in metropolitan La Paz. Int J Obstetr Gynaecol. 2009;116(9):1210-17.
Rakesh HJ, Diana V. Study of prevalence and factors associated with Maternal Near Miss (MNM) cases and maternal death at Rajiv Gandhi Government Women and Children Hospital, Pondicherry, India. Int J Reprod Contracept Obstet Gynecol. 2018;7(3):1049.
Almerie Y, Almerie MQ, Matar HE, Shahrour Y, Chamat AA, Abdulsalam A. Obstetric near-miss and maternal mortality in maternity university hospital, Damascus, Syria: a retrospective study. BMC Pregnancy Childbirth. 2010;10:65.
Yasmin G, Najam R, Ghazi S, Lalwani A. Maternal near miss events: A prospective observational study in a tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2016;5(9):3088-93.
Kamal S, Roy P, Singh S, Minz J. A study of maternal near miss cases at tertiary medical college of Jharkhand, India. Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2375-80.
Doreswamy N, Sudha TR, Tejaswary. Prevalence and outcome of maternal near miss in a tertiary care centre a cross sectional study at Hassan, Karnataka, India. Int J Clin Obstet Gynaecol. 2020;4(3):209-12.
Shrestha J, Shrestha R, Tuladhar R, Gurung S, Shrestha A. Maternal near miss in a tertiary care teaching hospital. Am J Public Health Research. 2015;3(5A):17-22.
Naz T, Akhter N, Naib JM, Gul N. Maternal near-miss morbidity and mortality-A continuum. J Med Sci. 2014;22:171-6.
Oladapo OT, Sule-Odu AO, Olatunji AO, Daniel OJ. “Near-miss” obstetric events and maternal deaths in Sagamu, Nigeria: A retrospective study. Reprod Health. 2005;2:9.
Lim SS, Dandona L, Hoisington JA, James SL, Hogan MC, Gakidou E. India's Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: An impact evaluation. Lancet. 2010;375(9730):2009-23.
Ameh C, Msuya S, Hofman J, Raven J, Mathai M, Van den Broek N. Status of emergency obstetric care in six developing countries five years before the MDG targets for maternal and newborn health. PLoS One. 2012;7(12):e49938.
Vora KS, Mavalankar DV, Ramani KV, Upadhyaya M, Sharma B, Iyengar S, et al. Maternal health situation in India: A case study. J Health Popul Nutr. 2009;27(2):184-201.
