A study of maternal near miss cases at tertiary care centre, Rajkot

Aayasha M. Darbar; Kavita Dudharejia; Kamal Goswami

doi:10.18203/2320-1770.ijrcog20253534

Authors

Aayasha M. Darbar Department of Obstetrics and Gynaecology, P.D.U. Hospital, Rajkot, Gujarat, India
Kavita Dudharejia Department of Obstetrics and Gynaecology, P.D.U. Hospital, Rajkot, Gujarat, India
Kamal Goswami Department of Obstetrics and Gynaecology, P.D.U. Hospital, Rajkot, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20253534

Keywords:

Maternal mortality, Maternal near miss, Severe maternal outcome, Mortality index

Abstract

Background: A maternal death is one of the most serious complications in obstetrics, with major impact on family members and staff involved. For every woman who dies from pregnancy or childbirth-related causes, it is estimated that twenty more suffer from pregnancy-related illness or experience other severe complications, these are considered as near-miss cases. The aim is to study the prevalence and clinical profile of maternal near miss in a tertiary care centre and assess the underlying socio-demographic variables, complications and contributing factors among near miss cases.

Methods: A hospital based prospective observational study was carried out at department of obstetrics and gynaecology at P.D.U medical college and hospital, Rajkot for the period of 18 months. The study population were the patients admitted in the department of obstetrics and gynaecology at P.D.U medical college and hospital, Rajkot. Selection of patients was according to WHO near miss criteria published in 2011. Demographic details, obstetric history along with past medical and surgical history were the main components in patient interview.

Results: 12916 live births occurred during the study period. Maternal near miss incidence was 15.79 per 1000 live births; Maternal near miss to mortality ratio was 4.34; Severe maternal outcome ratio was 19.43 per 1000 live births. Anaemia followed by hypertensive disorders in pregnancy were most common disorders seen in our study.

Conclusions: In order to decrease maternal mortality, awareness among general public, timely antenatal visits and early detection of complication and timely management is required.

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References

Sample registration system (SRS)-Bulletin 2014 volume 50-IIndia, 2016. Available at: https://censusindia.gov.in/nada/index.php/catalog/42707/download/46377/SRS_Bulletin_2014_Vol_50_No_1.pdf. Accessed on 25 July 2025.

Maternal Near Miss Operation Guideline: National Health mission, December 2014. Available at: Maternal_Near_Miss_Operational_Guidelines.pdf. Accessed on Accessed on 25 July 2025.

The Special Bulletin on Maternal Mortality in India, 2019-21 based on SRS 2019-21. Available at: https://censusindia.gov.in/nada/index.php/catalog/45561. Accessed on 25 July 2025.

World Health Organization from MDGs to SDGs: A New Era for Global Public Health. 2016-2030. Available at: https://unric.org/en/sdg-3/#. Accessed on 25 July 2025.

World Health Organization (WHO). Evaluating the quality of care for severe pregnancy complications: the WHO near-miss approach for maternal health. Geneva: WHO, 2011. Available at: https://iris.who.int/server/api/core/bitstreams/76b74bd5-af94-49d1-a538-ab989faba6bf/content. Accessed on 25 July 2025.

Visi V, Akoijam BS. A Review of Maternal Near Miss Cases in Selected Hospitals in North-East India. Indian J Community Med. 2021;46(3):421-4. DOI: https://doi.org/10.4103/ijcm.IJCM_476_20

Maternal mortality: Near-miss events in middle-income countries, a systematic review. Bulletin of the World Health Organization. 2021;99(10):693-707F. DOI: https://doi.org/10.2471/BLT.21.285945

Purandare C, Bhardwaj A, Malhotra M, Bhushan H, Chhabra S, Shivkumar P. Maternal near-miss reviews: lessons from a pilot programme in India. BJOG. 2014;121(4):105-11. DOI: https://doi.org/10.1111/1471-0528.12942

Singh A, Shrivastava C, Dube S. Maternal Near Miss: A Valuable Contribution in Maternal Care. J Obstet Gynaecol India. 201;66(1):217-22. DOI: https://doi.org/10.1007/s13224-015-0838-y

Bansal M, Lagoo J, Pujari K. Study of near miss cases in obstetrics and maternal mortality in Bastar, Chhattisgarh, India. Int J Reproduct Contracept Obstet Gynecol. 2017;5(3):620-3. DOI: https://doi.org/10.18203/2320-1770.ijrcog20160489

Dahie HA. Determinants of maternal near miss events among women admitted to tertiary hospitals in Mogadishu, Somalia: a facility-based case–control study. BMC Pregnancy Childbirth. 2022;22:658. DOI: https://doi.org/10.1186/s12884-022-04987-3

Patankar A, Uikey P, Rawlani N. Severe Acute Maternal Morbidity (Near Miss) in a Tertiary Care Center in Maharashtra: A Prospective Study. Int J Sci Stud. 2016;4(1):134-40.

Kulkarni R, Chauhan S, Fidvi J, Nayak A, Humane A, Mayekar R, et al. Incidence and factors influencing maternal near miss events in tertiary hospitals of Maharashtra, India. Indian J Med Res. 2023;158(1):66-74. DOI: https://doi.org/10.4103/ijmr.ijmr_2932_21

Chaudhari S, Nath S. Life-threatening Complications in Pregnancy in a Teaching Hospital in Kolkata, India. J Obstet Gynaecol India. 2019;69(2):115-22. DOI: https://doi.org/10.1007/s13224-018-1106-8

Pandey A, Das V, Agarwal A, Agrawal S, Misra D, Jaiswal N. Evaluation of obstetric near miss and maternal deaths in a tertiary care hospital in north India: shifting focus from mortality to morbidity. J Obstet Gynaecol India. 2014;64(6):394-9. DOI: https://doi.org/10.1007/s13224-014-0552-1

Doreswamy N, Sudha TR, Tejaswari. Prevalance 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. DOI: https://doi.org/10.33545/gynae.2020.v4.i3d.605

Mustafa R, Hashmi H. Near-miss obstetrical events and maternal deaths. J Coll Physicians Surg Pak. 2009;19(12):781-5.