Obstetric Near Miss Events in a Tertiary Research Level Teaching Hospital

Khatun, Tarannum; Rahman, Zarin; Parveen, Nuzhat; Ansari, Akhtar Alam; Mansuri, Mohammed Islam; Chaurasia, Anand Kumar

doi:10.3126/medphoenix.v2i1.18386

Cited by 3 publications

(5 citation statements)

References 1 publication

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“…In this study, 45.6% of near-miss cases were caused by PPH and 37% by hypertensive disorders. In comparison, the literature also reports hemorrhage and hypertensive disorders to be the major predictors of near-miss cases as well as maternal mortality [5-7].…”

Section: Discussionmentioning

confidence: 99%

“…Sepsis alone has been responsible for as many as 30% of maternal deaths in low-to-middle income countries [8-9]. It is the third leading cause of maternal mortality and near-miss events after hemorrhage and hypertensive disorders [2,7].…”

Section: Discussionmentioning

confidence: 99%

“…Some factors are associated with delay in reaching a tertiary care institution due to longer distances, lack of transport or funds. Factors related to health system include delay in providing immediate relief and/or referral, lack of adequate intensive care facility, well-trained staff, and others [7,10].…”

Section: Discussionmentioning

confidence: 99%

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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: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Spectrum of Near-miss Cases in Obstetrics

Sultana

Ishtiaque

Fareed

et al. 2019

Cureus

View full text Add to dashboard Cite

show abstract

“…In comparison, the literature also reports haemorrhage and hypertensive disorders to be the major predictors of near-miss cases as well as maternal mortality. [13][14][15] Some pregnancy-related complications leading to highrisk childbirth are almost unavoidable. The benefit of evaluating near-miss events in depth is that the records of these patients and the hindrances they had to witness can help in creating safer and more approachable obstetric healthcare for future patients.…”

Section: Discussionmentioning

confidence: 99%

Incidence of maternal near-miss events in a tertiary care hospital of Gujarat, India

Kansara

Vaja

Desai

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Maternal near miss is said to have occurred when women presented with life threatening complication during pregnancy, child birth and within 42 days after delivery, but survive by chance or good institutional care. For identifying near-miss cases five-factor scoring system was used. In 2009 WHO working group has standardized the criteria for selecting these cases. Because maternal mortality is a rare event, it is important to study maternal near-miss as a complement to evaluate and improve the quality of obstetric care. Thus, the study was conducted with the aim of assessing the incidence and causes of maternal near-miss.Methods: A facility-based cross-sectional study was conducted in the department of obstetrics and gynecology in GMERS medical college and hospital, Sola, Ahmedabad from January 1, 2019 to August 31, 2019. All maternal near-miss cases admitted to the hospital during the study period were recruited. World Health Organization criteria were used to identify maternal near-miss cases. The number of maternal near-miss cases over one year per 1000 live births occurring during the same year was calculated to determine the incidence of maternal near-miss. Underlying and contributing causes of maternal near-miss were documented from each participant’s record.Results: During the period of study, 3235 deliveries were done at the institution while 16 cases of near-miss were identified. The prevalence of near-miss case in this study was 0.5%. Near-miss per 1000 delivery was 5%. Maternal death to near miss ratio was 1:2.67. The leading causes of maternal near miss were hypertensive disorders (62%) and haemorrhage (32%) The morbidity was high in un-booked cases.Conclusions: Maternal near miss is good alternative indicator of health care system. Efforts made toward improvement in the management of life-threatening obstetric complications could reduce the occurrence of maternal near-miss problems that occur during hospitalization.

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“…In comparison, the literature also reports haemorrhage and hypertensive disorders to be the major predictors of near-miss cases as well as maternal mortality. [4][5][6] Some pregnancy-related complications leading to high-risk childbirth are almost unavoidable. The benefit of evaluating near-miss events in depth is that the records of these patients and the hindrances they had to witness can help in creating safer and more approachable obstetric health care for future patients.…”

Section: Discussionmentioning

confidence: 99%

A case of multiple fibroid uterus, complete placenta praevia, antepartum haemorrhage, myomectomy and obstetric hysterectomy: a near miss

Nimonkar¹,

Mahajan

Athul³

2021

Int J Reprod Contracept Obstet Gynecol

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An interesting case of young unbooked, unregistered, primigravida with multiple fibroid uterus, placenta praevia type IV, presented with APH in haemorrhagic Shock, impacted large fibroid in Lower Uterine Segment and Multiple fibroids on Anterior wall, fundus for which myomectomy was performed. Preterm Caesarean Section with extremely low birth weight infant delivered followed by life-saving Emergency Obstetric hysterectomy. She had uneventful recovery without any complications of massive transfusion or surgery. Case is being reported as an obstetric near miss.

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Obstetric Near Miss Events in a Tertiary Research Level Teaching Hospital

Cited by 3 publications

References 1 publication

Clinical Spectrum of Near-miss Cases in Obstetrics

Clinical Spectrum of Near-miss Cases in Obstetrics

Incidence of maternal near-miss events in a tertiary care hospital of Gujarat, India

A case of multiple fibroid uterus, complete placenta praevia, antepartum haemorrhage, myomectomy and obstetric hysterectomy: a near miss

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