Evaluation of Maternal Near Miss Events at Tibebe Ghion Specialized Hospital in Bahir Dar, Ethiopia

Abstract

Objective To estimate: 1) the prevalence of maternal mortality and severe morbidity (Maternal Near Miss (MNM)); and 2) associated risk factors, at a tertiary referral hospital in Bahir Dar, Ethiopia. Methods Prospective data collection of 658 consecutive delivering pregnant patients and their neonates at Tibebe Ghion Specialized Hospital (TGSH) in Bahir Dar, Ethiopia, from February 26-June 10, 2020. Demographic and outcome data were collected as part of a quality improvement initiative using the REDCap mobile app. Univariable and multivariable logistic regression were used to investigate the relationship between the key demographic and clinical variables with MNM. Results There were no maternal deaths and 70 MNM during the study period. The median patient age was 26 years (IQR 23-30); 49% of women were nulliparous, and 56% delivered vaginally. Patients had higher odds of experiencing MNM if living in a rural area (OR=3.71, p<0.01) or with a hypertensive disorder of pregnancy (OR=2.27, p=0.03). The postpartum hemorrhage rate was 1.7%. Conclusion The MNM and mortality rates at TGSH were less than elsewhere in the region. Living in a rural area and having hypertensive disorders of pregnancy were major predictors of MNM events. Multiple areas were identified where quality improvement projects could be developed.