Incidence of Maternal “Near-Miss” Events in a Tertiary Care Hospital of Central Gujarat, India

Parmar, Niyati; Parmar, Ajay; Mazumdar, Vihang

doi:10.1007/s13224-016-0901-3

Cited by 25 publications

(23 citation statements)

References 8 publications

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“…This study revealed the incidence of near-miss to be 30.1/1,000 obstetric admissions and 31.4/1,000 live births which is comparably higher than the regional literature. In recent Indian studies, near-miss rate was 20.6/1,000 obstetric admissions [4] and 17.8/1,000 live births [2]. The ratio of maternal near-miss to mortality was reported to be 5.6:1 and 2.6:1 [2,4], as compared to 3.8:1 in this study.…”

Section: Discussionmentioning

confidence: 40%

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Clinical Spectrum of Near-miss Cases in Obstetrics

Sultana

Ishtiaque

Fareed

et al. 2019

Cureus

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Introduction Near-miss obstetric cases are the ones which have survived childbirth after a life-threatening and complicated pregnancy. The aim of this study is to evaluate important characteristics and causes of near-miss cases, compare them with maternal deaths, and assess urgent interventions managing these patients. Materials and methods This prospective, cross-sectional study was conducted in the intensive care unit of the Obstetrics and Gynecology department. Clinical spectrum of near-miss patients was compared with that of maternal deaths. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) Statistics for Windows, version 21.0 (IBM Corp., Armonk, NY). Results The incidence of near-miss events was 31.4/1,000 live births. The incidence of maternal mortality was 8.2/1,000 live births. The ratio of near-miss to maternal mortality was 3.8:1. Hemorrhage, hypertensive disorders, and puerperal sepsis were the leading causes of near-miss cases. Conclusion Evaluation of characteristics of near-miss cases helps in establishing severe maternal morbidity. These high-risk patients must be provided urgent interventions to prevent maternal mortality.

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Section: Discussionmentioning

confidence: 40%

“…In recent Indian studies, near-miss rate was 20.6/1,000 obstetric admissions [4] and 17.8/1,000 live births [2]. The ratio of maternal near-miss to mortality was reported to be 5.6:1 and 2.6:1 [2,4], as compared to 3.8:1 in this study. In an Ethiopian study, it has been reported to be 8.01/1,000 live births [5].…”

Section: Discussionmentioning

confidence: 40%

Clinical Spectrum of Near-miss Cases in Obstetrics

Sultana

Ishtiaque

Fareed

et al. 2019

Cureus

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“…Both MNMR and SMOR give an estimate of the amount of care and resources that would be needed to improve obstetric care in that area or facility. We reviewed studies done in different parts of India, and the near-miss ratio ranged from 120 to 10.4 ( Table 12) [10][11][12][13][14][15][16][17][18][19][20][21][22]. However, all these studies have used different criteria in identifying near-miss cases and hence technically not ideal for comparison.…”

Section: Discussionmentioning

confidence: 99%

Maternal Near-Miss as a Surrogate Indicator of the Quality of Obstetric Care: A Study in a Tertiary Care Hospital in Eastern India

Singh¹,

Barik²

2021

Cureus

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Background Monitoring severe acute maternal morbidity or maternal near-miss is currently proposed by WHO as a valuable tool to assess the quality of obstetric care and implement new strategies for improving maternal health. Aim and objective The objective of this study was to assess and analyze the incidence of maternal near-miss (MNM) and maternal death (MD) at Tata Main Hospital, Jamshedpur, a tertiary care hospital in eastern India. Material and method This study was a prospective observational study conducted at Tata Main Hospital from November 2016 to October 2019. The study population included all the pregnant women who fulfilled the WHO near-miss criteria based on organ dysfunction or failure and all the maternal deaths that occurred during the study period. Results During the study period, there were 15,377 deliveries and 14,636 live births. The MNM cases were 153, and 38 were maternal deaths. The maternal near-miss ratio (MNMR) and severe maternal outcome ratio (SMOR) were 19.9 and 13.1 per 1000 live births, respectively. The maternal near-miss to mortality ratio (MNM: 1 MD) was 4:1, and the mortality index (MI) was 19.9%. Haemorrhagic disorders were the leading cause (40.5%) of MNM, followed by hypertensive disorders (25.5%) and cardiac diseases (14.4%). Similarly, both haemorrhage (23.7%) and sepsis (23.7%) were the leading causes of death followed by hypertensive disorders (15.8%). On reviewing patients, 62% of near-miss and 92% of mortality cases had shown organ dysfunction on admission. Conclusion MNM and MD cases share similar pathology with a different outcome. Hence, monitoring a larger volume of MNM cases helps in identifying the causes of maternal adverse events and finding out the gaps in the management more effectively than auditing only the maternal deaths.

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“…2 The maternal mortality of India is presently 130/100,000 live births, although showing a large regional variation. 3 It is 300/lakh live births for Assam and 67/lakh live births in Kerala.…”

Section: Introductionmentioning

confidence: 99%

A longitudinal study of near-miss and maternal mortality at a tertiary centre in rural Uttarakhand: addressing the fourth delay

Mangla

Nautiyal

Deepmala

2019

Int J Reprod Contracept Obstet Gynecol

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Background: India is a signatory of the sustainable development goals and is committed to reduce the maternal mortality ratio to less than 70 per lakh live births. Review of maternal deaths and near miss cases is a very important step towards achieving this aim.Methods: A prospective observational study was carried out in a tertiary care centre in rural Uttarakhand for a period of one and half year using WHO criteria for maternal near-miss, in an attempt to assess the quality of obstetric care in the region and to identify the possible delays leading to this.Results: Haemorrhage was the most common cause leading to severe maternal outcome, followed by early pregnancy complications and hypertensive disorders of pregnancy. The mortality index was 15% and maternal near miss to mortality ratio was 7:1. We could identify some type of delay in at least 70% of near miss and mortality cases. Although delay in seeking healthcare was the most common, lack of community participation was identified as an important fourth delay.Conclusions: For substantive reduction of maternal mortality in this region of Uttarakhand, the main action needed is strengthening of primary health care, educating the patients regarding warning signs of pregnancy and strengthening the social status of women in society, increasing community support in women health care.

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Incidence of Maternal “Near-Miss” Events in a Tertiary Care Hospital of Central Gujarat, India

Cited by 25 publications

References 8 publications

Clinical Spectrum of Near-miss Cases in Obstetrics

Clinical Spectrum of Near-miss Cases in Obstetrics

Maternal Near-Miss as a Surrogate Indicator of the Quality of Obstetric Care: A Study in a Tertiary Care Hospital in Eastern India

A longitudinal study of near-miss and maternal mortality at a tertiary centre in rural Uttarakhand: addressing the fourth delay

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