DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20183345

A study of maternal near miss cases in tertiary health centre in north India

Lovepreet Kaur, Manjit Kaur Mohi, Balwinder Kaur, Beant Singh

Abstract


Background: Maternal near miss is defined as woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy.

Methods: It was one-and-a-half-year prospective study from April 2016 to September 2017 conducted in the department of Obstetrics and Gynecology, Government Medical College, Patiala. The causes of maternal near miss based on WHO 2010 Near Miss criteria were studied.

Results: In the present study out of total deliveries of 6166, there were 5461 live births and 123 maternal near miss cases which were included based on WHO 2010 maternal near miss approach. The maternal near miss incidence ratio (MNMR) in present study is 22.5. Literature reports the similar trends and MNMR varies between 15 to 40 per 1000 live births. Maternal near miss to mortality ratio is 1.89:1 in the present study.

Conclusions: The most common direct cause for maternal near miss is hemorrhage. Severe preeclampsia is one of the easiest identifiable and avoidable factors for preventing maternal death. Studying near miss in detail allows us proper assessment of opportunities that were missed, analyzing the gaps and patient care related factors and helps to develop an audit system for maternal care.


Keywords


Causes, Maternal near miss, WHO criteria

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References


WHO (2005), Improving maternal, newborn and child health in the South-East Asia Region, New Delhi.

WHO (1998), World Health Report 1998, Life in the 21st century, a Vision for all, Report of Director General, WHO.

Govt. of India (2013), Special Bulletin on Maternal Mortality in India 2010-12, SRS, Dec. 2013, Office of Registrar General of India.

Brace V, Penney G, Hall M. Quantifying severe maternal morbidity: a Scottish population study. BJOG. 2004;111:481.

Say L, Souza JP, Pattinson RC. WHO working group on maternal mortality and morbidity classifications. Maternal near miss- towards a standard tool for monitoring quality of maternal health care. Best Pract Res Clinical Obstet Gynecol. 2009;23:287-96.

Souza JP, Cecatti JG, Parpinelli MA, Serruya SJ, Amaral E. Appropriate criteria for identification of near miss maternal morbidity in tertiary care facilities: a cross sectional study. BMC Pregnancy Childbirth. 2007;7(20):1-8.

Bansal M, Lagoo J, Pujari K. Study of near miss cases in obstetrics and maternal mortality in Bastar, Chhattisgarh, India. Int J Reprod Contracep Obstet Gynecol. 2017 Feb 23;5(3):620-3.

Kalra P, Kachhwaha CP. Obstetric near miss morbidity and maternal mortality in a Tertiary Care Centre in Western Rajasthan. Indian J Public Health. 2014 Jul 1;58(3):199.

Maternal near miss operational guidelines. December 2014, ministry of health and family welfare, Government of India.

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 Gynecol India. 2014 Dec 1;64(6):394-9.

Rajakumari P, Manonmani. Maternal near Miss: an indicator of Maternal health. IOSR J Dental Med Sci. 2017;3(16):9-15.