Maternal Near Miss in a Tertiary Care Hospital: A Cross Sectional Study

Ray, Namrata; Patil, Sanjay Kumar; S, Nitin Kshirsagar; Patil, Yaminni; Laddad, Manisha

doi:10.14260/jemds/2016/755

Cited by 3 publications

(3 citation statements)

References 12 publications

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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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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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“…Close figures of 45.6% were observed by Sultana S et al in their study 2 .Most of the cases in this group were referred from private clinics or periphery, received in very critical condition and needed blood transfusions and peripartum hysterectomies. Ray N et al observed 38.5% of their near miss cases attributed to haemmorhage 1 .…”

Section: Discussionmentioning

confidence: 98%

“…The purpose of maternal health care services is to improve the standards of obstetric care keeping in view the inquiries on the maternal deaths 1 .Severe acute maternal morbidity or near miss events in terms of obstetrics means a women who escaped a life threatening situation of medical disorder, organ dysfunction, or some event during the course of her pregnancy or delivery 2 .These cases are similar in their pathological, physiological and clinical basis with the maternal mortality cases 3 .…”

Section: Introductionmentioning

confidence: 99%

Audit of Maternal Near Miss Cases in A Tertiary Care Hospital of Mardan

Qadir¹,

Khan²

2023

PJMHS

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Aim: To determine the frequency and causes of maternal near miss events at a tertiary care hospital of Mardan. Methodology: This descriptive cross sectional study was conducted at Gynaecology department of Mardan Medical Complex from January 2018 to December 2019.Cases of maternal near miss events were collected from the records of women who met the WHO criteria for near miss. All the data was entered into structured proforma and analysis done. Results: Total near miss cases were 215 and totallive births were 9,228. The near miss rate was 23/1000 and maternal near miss to maternal mortality ratio was 3.7:1.Mean age was 26±3.2 years.Age group of 21-30 years was the high risk group with 112(52%) cases, followed by 31-40 years age group with 81(38%) cases. 89(41%) patients were multigravidas and 77(36%) were grand multi gravidas. Gestational age of more than 28 was seen in 146(68%) women and less than 28 weeks in 17(8%) whereas 52(24%) were postnatal.184(86%) were unbooked cases. Regarding the causes of near miss events, haemmorhage was seen in 96(45%), hypertension in 53(24.6%), Sepsis in 26(12%), cardiac disease in 10(4.6%), anaphylactic shock in 8(4%), anesthetic complications in 6(3%), epilepsy and hepatic encephalopathy in 4(2%) each and 8(4%) were due to indirect causes. Conclusion: Near miss cases have many similarities with maternal deaths and give us knowledge about the issues that need to be solved in order to reduce the grave situations where a maternal death can be prevented. Keywords: Near miss, Mortality, Morbidity, Haemmorhage, Hepatic Encephalopathy, Sepsis

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The global prevalence of maternal near miss: a systematic review and meta-analysis

Abdollahpour

Miri

Khadivzadeh

2019

Health Promot Perspect

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Background: Improving the maternal health is one of the world’s most challenging problems. Despite significant movements over the past decades, maternal health has been still considered as a central goal for sustainable development. Maternal near miss (MNM) cases experience long-term physical and psychological effects. To present a clear portrait of the current situation, we performed a systematic review and meta-analysis with the purpose to assess the worldwide prevalence of MNM. Methods: We conducted a systematic review on PubMed, Scopus and Web of Science electronic databases to find published papers in English, before March 2019 and regardless of the type of study. We, then, assessed the prevalence of MNM according to the World Health Organization(WHO) criteria. Finally, 49 papers were included in the study. Random effects meta-analysis was used to pool the available prevalence. The quality of studies was also evaluated. Results: The weighted pooled worldwide prevalence of MNM, was 18.67/1000 (95% CI: 16.28-21.06). Heterogeneity was explored using subgroup analyses based on the continent and the country. We used meta-regression of MNM on MD which resulted in adjusted R-squared as78.88%. Conclusion: The prevalence of MNM was considerable. Low- and middle-income countries should develop systematic approaches to improve quality of care in the facilities and to reducethe risk of MNM events, with the hope to women’s health.

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Maternal Near Miss in a Tertiary Care Hospital: A Cross Sectional Study

Cited by 3 publications

References 12 publications

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

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

Audit of Maternal Near Miss Cases in A Tertiary Care Hospital of Mardan

The global prevalence of maternal near miss: a systematic review and meta-analysis

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