Maternal near-miss in a rural hospital in Sudan

Abstract

BackgroundInvestigation of maternal near-miss is a useful complement to the investigation of maternal mortality with the aim of meeting the United Nations' fifth Millennium Development Goal. The present study was conducted to investigate the frequency of near-miss events, to calculate the mortality index for each event and to compare the socio-demographic and obstetrical data (age, parity, gestational age, education and antenatal care) of the near-miss cases with maternal deaths.MethodsNear-miss cases and events (hemorrhage, infection, hypertensive disorders, anemia and dystocia), maternal deaths and their causes were retrospectively reviewed and the mortality index for each event was calculated in Kassala Hospital, eastern Sudan over a 2-year period, from January 2008 to December 2010. Disease-specific criteria were applied for these events.ResultsThere were 9578 deliveries, 205 near-miss cases, 228 near-miss events and 40 maternal deaths. Maternal near-miss and maternal mortality ratio were 22.1/1000 live births and 432/100 000 live births, respectively. Hemorrhage accounted for the most common event (40.8%), followed by infection (21.5%), hypertensive disorders (18.0%), anemia (11.8%) and dystocia (7.9%). The mortality index were 22.2%, 10.0%, 10.0%, 8.8% and 2.4% for infection, dystocia, anemia, hemorrhage and hypertensive disorders, respectively.ConclusionThere is a high frequency of maternal morbidity and mortality at the level of this facility. Therefore maternal health policy needs to be concerned not only with averting the loss of life, but also with preventing or ameliorating maternal-near miss events (hemorrhage, infections, hypertension and anemia) at all care levels including primary level.

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

“…Waterstone M et al criteria were not used in our study as in some instances identifying ''nearmiss'' using these criteria overestimates near-miss cases. During this study, depending on the criteria used, overall maternal near-miss ratio was found to be 23.85/1000 live births, which is within the range of ratios (12.3-82.3 per 1000 deliveries) reported in various studies using similar criteria for near-miss definition [15,16] Observed ratio of maternal near-miss event to maternal death was 2.6 in our study, while it was 8.6 in a study conducted by Fátima A L et al in Brazil [8].…”

Analysis of Near Miss Cases as a Reflection of Emergency Obstetric Services and Need of Obstetric ICCU

“…7 However, their MMR (70.1, 54.8 and 432) and mortality index (1.8, 1.67 and 19.5%) are much lower than our study MMR (832.8) and mortality index (27.8%). For every 2.5 women who survived NME, 1 expired.…”

Maternal Near Miss and Still birth in developing countries: A Systematic Review with Meta-Analysis

“…In some of the African countries like Gambia, Nigeria and Sudan a higher risk of still birth was also observed among women of near miss when compared to women without near miss [17][18][19][20]. Hence, this is indicative of the link between still birth and maternal near miss.…”