Study of maternal near miss cases at a tertiary centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20250514Keywords:
Maternal near miss, Maternal mortality, Obstetric haemorrhageAbstract
Background: When evaluating the quality of a women's health care system, maternal mortality serves as a sentinel occurrence. Since death rates are steadily declining, attention is now being paid to maternal near misses, which characterize severe maternal morbidity and have a shared pathway with mortality.
Methods: This is a retrospective descriptive study carried out in department of obstetrics and gynaecology of Khaja Banda Nawaz University- Faculty of medical sciences, over six months. All women who fulfil the World Health Organisation (WHO) criteria of Maternal Near Miss (MNM) were included in the study. Relevant demographic and obstetric, further course and events leading to maternal near miss were studied. Finally, the indices like maternal near miss incidence ratio, maternal near miss: maternal mortality ratio and mortality index were calculated.
Results: Total 124 women were recognized as near-miss instances out of 812 deliveries that occurred at our institution throughout the 6 months research period. The prevalence of near-miss case was 2.56%. The maternal near-miss to death ratio was 124:2, and the maternal near-miss ratio was 155 per 1000 live births. The most frequent cause of maternal near misses was obstetric haemorrhage, which occurred in 44.1% of cases, while the most prevalent medical co-morbidity was hypertensive condition of pregnancy (60.1%). Referral cases made up the majority of the cases (79.2%).
Conclusions: Analysing maternal near-miss incidents provides valuable insight into our healthcare system. Peripheral emergency obstetric care training contributes to a decrease in maternal morbidity overall and lessens the strain on healthcare system.
Metrics
References
Tura AK, Scherjon S, Stekelenburg J, van Roosmalen J, van den Akker T, Zwart J: Severe hypertensive disorders of pregnancy in eastern Ethiopia: comparing the original WHO and adapted sub-Saharan African maternal near-miss criteria. Int J Womens Health. 2020;12:255-63. DOI: https://doi.org/10.2147/IJWH.S240355
Pattinson R, Say L, Souza JP, Broek Nv, Rooney C. WHO maternal death and near-miss classifications. Bull World Health Organ. 2009;87:734. DOI: https://doi.org/10.2471/BLT.09.071001
World Health Organization. Evaluating the Quality of Care for Severe Pregnancy Complications: The WHO Near-Miss Approach for Maternal Health; 2011.
Naderi T, Foroodnia S, Omidi S, Samadani F, Nakhaee N: Incidence and correlates of maternal near miss in southeast Iran. Int J Reprod Med. 2015;2015(1):914713. DOI: https://doi.org/10.1155/2015/914713
Bindal J, Solanki G. Clinical and etiological study of maternal near-miss at a tertiary referral hospital of central India. Ind J Obstet Gynaecol Res. 2016;3(1):28-31. DOI: https://doi.org/10.5958/2394-2754.2016.00006.0
Minkauskiene M, Nadisauskiene R, Padaiga Z, Makari S: Systematic review on the incidence and prevalence of severe maternal morbidity. Medicina (Kaunas). 2004;40(4):299-309.
Purandare C, Bhardwaj A, Malhotra M, Bhushan H, Chhabra S, Shivkumar P. Maternal near‐miss reviews: lessons from a pilot programme in India. BJOG: An Int J Obstetr Gynaecol. 2014;121:105-11. DOI: https://doi.org/10.1111/1471-0528.12942
World Health Organization. W HO, UNFPA, the world bank: Maternal mortality 2005. Estimates developed by WHO, UNICEF, UNFPA, and the world bank; 2007.
Nielsen HS, Eggebo TM. Millenium development Goal 5 - an obstetric challenge. Acta Obstetricia et Gynecolog Scand. 2012;91(9):1007-8. DOI: https://doi.org/10.1111/j.1600-0412.2012.01505.x
Sultana R, Jameel A, Amjad A. Obstetrical Near Miss and maternal deaths at district hospital Karachi, Pakistan. Pak J Surg. 2014;30(3):272-78.
Say L, Souza JP, Pattinson RC. Maternal near miss towards a standard tool for monitoring quality of maternal health care. Best Pract Res. 2009;23(3):287-96. DOI: https://doi.org/10.1016/j.bpobgyn.2009.01.007
Bansal M, Lagoo J, Pujari K. Study of near miss cases in obstetrics and maternal mortality in Bastar, Chhattisgarh, India. Int J Reprod Contracept Obstet Gynecol. 2016;5(3):620-23. DOI: https://doi.org/10.18203/2320-1770.ijrcog20160489
Roopa PS, Shailia V, Lavanaya R, Pratap K. “Near Miss” obstetrics events and maternal deaths in a tertiary care hospital: an audit. J Pregna. 2013;2013(2013). DOI: https://doi.org/10.1155/2013/393758
Shaheen F, Begum A. Maternal “Near Miss”. J Rawalpi Med Coll. 2014;18(1):130-32.
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. DOI: https://doi.org/10.18203/2320-1770.ijrcog20172316
Shrestha NS, Saha R, Karki C. Near miss maternal morbidity and maternal mortality. Kathmandu University Med J. 2010;8(30):222-26. DOI: https://doi.org/10.3126/kumj.v8i2.3563
Nacharaju M, Sunita Sudhir P, Kaul R, Reddy P. “Maternal near miss: an experience in Rural Medical College”. J Evolut Medi Dent Sci. 2014;3(56):12761-67. DOI: https://doi.org/10.14260/jemds/2014/3693
Ali AA, Khojali A, Okud A, Adam GK, Adam I. Maternal near-miss in a rural hospital in Sudan. BMC Pregnan Childb. 2011;11(48):2-4. DOI: https://doi.org/10.1186/1471-2393-11-48
Downloads
Published
How to Cite
Issue
Section
