A prospective observational study on maternal near miss cases in a rural teaching hospital
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20214640Keywords:
Maternal near miss, Maternal mortality, Mortality indexAbstract
Background: Women who have survived complications during pregnancy and child birth have been studied and termed Maternal near miss (MNM). All near misses should be interpreted as free lesson and opportunities to improve the quality of service provision. The aim of the study was to know the incidence, risk factors and underline causes of MNM in our setup as there is limited data from Himachal Pradesh.
Methods: The present study was a prospective observational study that was carried out in the department of Obstetrics and Gynecology, Dr. Rajendra Prasad Government Medical College Kangra at Tanda (HP), from 1st January 2018 to 31st December 2018. The patients in this study were, pregnant women who nearly died but survived a complication that occurred during pregnancy, child birth or within 42 days of termination of pregnancy as per WHO MNM criteria 2009.
Results: A total of 9690 live births, 5 maternal deaths and 116 MNM cases were reported during the study period. Incidence of MNM observed was 12%. Hypertensive disorders of pregnancy 39.6% cases were most common cause for MNM followed by obstetric hemorrhage 31.03% cases. Majority of neonates i.e.; 58% were admitted to NICU and only 52.7% survived the postnatal complications.
Conclusions: Critical analysis of MNM cases will help us in identifying the deficiencies in obstetric care. Maternal mortality and morbidity can be reduced if timely and effective care can be given to women experiencing acute pregnancy related complications. There is need for validation of ‘MNM’ criteria at peripheral levels which will enable them in early identification and timely referral of such cases to tertiary centers.
References
National Health Mission. Home, 2019. Available at: https://mohfw.nic.in/maternalhealth.htmp. Accessed on 20 August 2021.
UN. 2. Sustainable development goals:17 goals to transform our world, 2019. A https://www.un.org/sustevelopment/health. Accessed on 20 August 2021.
Chikadaya H, Madziyire MG, Munjanja SP. Incidence of maternal near miss in the public health sector of Harare, Zimbabwe: a prospective descriptive study. BMC Pregnancy Childbirth. 2018;18(1):458.
Parmar N, Parmar A, Mazumdar VS. What can we miss in identifying ‘maternal near miss’ event? IJCRR. 2014;6:45-50.
WHO. Evaluating the quality of care for severe pregnancy complications. The WHO near miss approach for maternal health, 2019. Available at: https://www.who.int/reproductivehealth/publications/monitoring/9789241502221/en. Accessed on 20 August 2021.
Yelikar KA, Deshpande SS, Deshmukh SF. Severe Acute Maternal Morbidity in a Tertiary Care Center with Basic Intermediate Respiratory Care Units Setup. Int J Sci Stud. 2015;3:36-40.
Bakshi RK, Aggarwal P, Roy D, Nautial R. Indicators of maternal “near miss” morbidity at different levels of health care in North India: A pilot study. Bangladesh J Med Sci. 2015;14:254-57.
Kaur S, Minhas S, Sharma BR, Sood R. Maternal near miss and maternal mortality as health indicators in a tertiary care hospital. J Evolut Med Dent Sci. 2014;3:10354-62.
Kaur K, Garg S, Walia SS. A one year audit of maternal near miss and maternal death at tertiary care hospital. JMCSR. 2018;6:705-10.
Verma S, Rai L, Kumar P, Pai MV, Shetty J. "Near miss" obstetric events and maternal deaths in a tertiary care hospital: an audit. J Pregnancy. 2013;2013:393758.
Patanakar A, Uikey P, Rawlani N. Severe Acute Maternal Morbidity (Near Miss) in a Tertiary Care Center in Maharashtra: A Prospective Study. Int J Sci Stud. 2016;4:134-40.
Samant PY, Dhanawat J. Maternal near miss: an Indian tertiary care center audit. Int J Reprod Contracept Obstet Gynecol. 2019;8:1874-9.
Taly A, Gupta S, Jain N. Maternal intensive care and ‘Near-miss’. Mortality in obstetrics. J Obstet Gynecol India. 2004;54:478-82.
Roost M, Altamirano V, Liljestrand J, Essen B. Priorities in emergency obstetrics care in Bolivia-maternal mortality and near miss morbidity in metropolitan La Paz. BJOG. 2019;116:1210-17.
Manandhar SR, Manandhar D, Adhikari D, Shreshta J, Rai C, Rana H, et al. Analysis of obstetrics near miss cases of different health facilities of electoral constituency 2 of Arghakhanchi district. Nepal J Obstet Gynecol. 2014;18:38-41.
Kalra P, Kachhwaha CP. Obstetrics near miss morbidity and maternal mortality in a Tertiary care center in Western Rajasthan. Indian J Public Health. 2014;58:199-201.