Maternal Near Miss at a Tertiary Teaching Hospital in Mekelle, Ethiopia [21L

Abstract

INTRODUCTION: A peripartum near-miss event occurs when a woman nearly dies, but survives a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy. As maternal deaths are rare occurrences, near-miss cases can be used instead to elucidate the events leading to complications and the obstacles that must be overcome to treat complications, hence providing valuable information on obstetric care. This study aimed to assess maternal near miss at Ayder Referral Hospital (ARH). METHODS: Our study was a retrospective chart review of near miss cases seen at ARH between July 1, 2016 and June 30, 2017. WHO near miss criteria was used to select cases. RESULTS: Over the study period, there were 3,899 deliveries, 236 near miss, and 13 maternal deaths at ARH. The leading causes of near miss were hemorrhage (41.9%), hypertensive disorders of pregnancy (41.1%), sepsis (9.3%), labor abnormality (4.6%), and medical disorders of pregnancy (3.6%). In terms of timing of near miss diagnosis, 37.7% occurred antenatally, 25% intrapartum, 32% postpartum, and 5.1% post abortion. 86% of cases were referred from other health facilities. Majority of the patients (80%) arrived to our hospital in critical condition. Ninety percent of the near miss cases had antenatal care (ANC) at health center. CONCLUSION: Near miss is substantial problem in North Ethiopia. Most referred patients arrived in critical condition, suggesting support and transportation from referring institutions should be improved. Additional research is need to assess the quality ANC given that 90% of the near miss cases had ANC.