DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20215098

Feto-maternal outcomes in near miss events in obstetrics

Apoorva Kamboj, Kavita Mandrelle

Abstract


Background: Maternal near miss is defined by world health organization as a woman, who being close to death survives a complication occurring during pregnancy, delivery or upto 42 days after her end of pregnancy.It is a retrospective diagnosis. Evaluation of near miss maternal morbidity and mortality is a surveillance method to assess the quality of obstetric care and determinants of poor maternal outcome. It is an indicator of quality of obstetrical care. Aims and objectives for current study was to evaluate the cause of near miss maternal morbidity in our hospital which occurred either in admitted patients or were referred from elsewhere and to study the maternal and fetal outcomes in all near miss cases.

Methods: A retrospective review of obstetrical records as well as prospective analysis was done at Christian medical college and hospital, a tertiary care teaching institute in North India and referral centre. The study was done for a period of one year from November 2018 to October 2019 retrospectively and for 6 months from November 2019 to April 2020 prospectively. The maternal near miss cases were taken as per WHO criteria.

Results: The age ranged from 19 years to 49 years with maximum belonging to age group of 20-24 years. Maximum number of cases was primigravida and was in third trimester. The primary obstetric complication evaluated were hypertensive disorders followed by hematological diseases, viral hepatitis, haemorrhage, and obstructed labour or ruptured uterus.

Conclusions: All the causes of MNM observed in this study are preventable causes, which can be identified timely and treated early to prevent maternal mortality, thereby, improving obstetrical and neonatal outcome.


Keywords


Near miss events in obstetrics, Feto- maternal outcomes

Full Text:

PDF

References


Geller S, Rosenberg D, Cox S. Defining a conceptual framework for near miss maternal morbidity. J Am Med Women Assoc. 2002;57:135-9

Le Bacq F, Reitsema A. High maternal mortality levels and additional risks from poor accessibility in two districts of northern province, Zambia. Int J Epidemiol. 1997;26:357-63

Kaye DK, Kakaire O, Osinde MO. Systematic review of the magnitude and case fatality ratio for severe maternal morbidity in sub-Saharan Africa between 1995 and 2010. BMC Preg Childbirth. 2011;11:65

Adisasmita A, Deviany PE, Nandiaty F, Stanton C, Ronsmans C. Obstetric near miss and deaths in public and private hospitals in Indonesia. BMC Preg Childbirth. 2008;8:10

The Millennium Development Goals Report 2008. Available at: https://www.un.org/millenniumgoals/ 2008highlevel/pdf/newsroom/mdg%20reports/MDG_Report_2008_ENGLISH.pdf. Accessed on 25 September 2021.

Say L, Souza JP, Pattinson RC, WHO working group on maternal mortality and morbidity classifications: maternal near miss-towards a standard tool for monitoring quality of maternal health care. Best Pract Res Clin Obstet Gynaecol. 2009;23(3):287-96

Shrestha J, Shrestha R, Tuladhar R, Gurung S, Shrestha A. Maternal near miss in a tertiary care teaching hospital. Ame J Public Health Res. 2015; 3(5A):17-22.

Gedefaw M, Gebrehana H, Gizac$hew A, Taddess F. Assessment of maternal near miss at debremarkos referral hospital, Northwest Ethiopia: five years’ experience. J Epidemiol. 2014;4:199-207.

Wianwiset W. Maternal near miss (severe morbidity) at Sisaket Hospital. J Obstet Gynecol. 2012;20:69-76.

Kabakyenga JK, Ostergren PO, Turyakira E, Mukasa PM, Pettersson KO. Individual and health facility factors and the risk for obstructed labor and its adverse outcomes in South-Western Uganda. BMC Preg Childbirth. 2011;11:73.

Oladapo OT, Sule-Odu AO, Olatunji AO, Daniel OJ. Near-miss obstetric events and maternal deaths in Sagamu, Nigeria: a retrospective study. Reprod Health. 2005;2:1186-95.

Sikeder SS, Labrique AB, Ullah B, Ali H, Rashid M, Mehra S, et al. Accounts of severe acute obstetric complications in rural Bangladesh. BMC Preg Childbirth. 2011;11:76.

Olufemi T, Oladapo A. Near-miss obstetric events and maternal deaths in Sagamu, Nigeria: a retrospective study. Reprod Health. 2005;2:9.