Even though they are quite uncommon, puerperal genital haematomas can be associated with serious maternal morbidity. Key findings are significant perineal pain and, depending on the location, visible swelling. However, attention can be drawn to its progression by the rare occurrence of persistent painful “bearing down” efforts, even after the successful delivery of the baby. The final size of this haematoma and the rare presentation make it truly uncommon. The primary goals of treatment include the prevention of further blood loss, minimizing tissue damage, relieving pain, and reducing the risk of infection. Management is generally conservative for small collections, but surgery is indispensable when they acutely expand in size or are large with worsening symptoms.

Background: Maternal near miss (MNM) concept is becoming a tool for the assessment of severe maternal morbidity. The study examined the profile of MNM cases and their determinant factors.Methods: A cross-sectional study of pregnant women with near miss cases and maternal death using the WHO criteria between 1st January 2015 and 31st December 2016. Relevant data were collected with using a structured data form, analyzed using SPSS version 22 and logistic regression was done to determine factors associated with MNM.Results: The MNM incidence ratio was 17.4/1000 live births with overall mortality index of 17.5%. Hemorrhage (39.4%) was the commonest cause of MNM while uterine rupture (42.8%) was the most common cause of maternal death. Also, uterine rupture had the highest mortality index of 33.3%. Older age group, low education, rural dwellers and unbooked status of women were the significant determinants of MNM, p <0.05. The overall maternal death to near miss ratio was 1:4.7. The worst perinatal outcome occurred in women who suffered maternal death.Conclusions: The study showed suboptimal level of care for women with life threatening conditions. There is a need to develop evidence-based protocol for their management and provision of high dependency unit.

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