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

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.

Maternal Near-miss in Tertiary Referral Center: A Prospective Observational Study from Urban Bengaluru

“…As in other studies, hemorrhage was reported as a leading cause of death. 7,10 Prompt referral, adequate transportation, active management of the third stage of labor, and postpartum care must be strengthened to reduce MNM and maternal deaths due to PPH and sepsis. Existing comorbidities such as cardiac disease and liver disease were also found to have high mortality index.…”

A study to assess the occurrence and factors of maternal near-miss among women admitted in maternal unit in selected hospitals of Kolkata, India

“…Hemorrhage was the major cause (43.5%) of maternal near-miss followed by severe anaemia (15.38%), rupture uterus (15.38%), pre-eclampsia / eclampsia (12.82%), sepsis (5.12%), complicated malaria (5.12%) and hepatitis (2.56%) were recorded. 8 Most common direct complications of pregnancy were hemorrhage (26%), eclampsia (18.7%), sepsis (9.8%), ruptured uterus (4%) and obstructed labour (3.2%) as per study of Kaur et al 9 The indirect causes were recorded as anaemia (34.1%), respiratory disease (4%), liver disease (5.7%) and heart disease (1.6%).…”