Maternal Near Miss: A Bigger Challenge

Abstract

Introduction:Maternal near-miss case is new concept and is defined as a woman who nearly died but survived complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy”.The objectives of the present study were: to identify among all women admitted to hospital during pregnancy, delivery and in the postpartum period those that were indicative of severe acute maternal morbidity; to find out and analyse the cause of hospitalization. Materials & methods:This was descriptive study done for period of 24 months between 1st January 2013 and 31st December 2014 in our hospital. Cases of severe obstetric morbiditywere analyzed in regard to characteristics like age, parity, and gestational age at admission, Intensive Care Unit (ICU) admission, and surgical intervention to save the life of the mother were considered. Maternal near miss (MNM) indices were calculated. Results:There were 150 cases of near miss, 3123 live births and 9 cases of maternal deaths. Maternal near miss incidence ratio is 48.03. Maternal near miss mortality ratio is 16.66. Mortality index (MI)is 5.66%. Mostly near miss cases were antenatal at >28 weeks of gestation with hemorrhage and hypertension being commoner causes responsible. The highest mortality index was found with cardiac causes (25%) followed by sepsis (16.6%) and eclampsia (14.2%). Conclusion:All near misses should be interpreted as free lessons and opportunities to improve the quality of service provision.