A Study of Near Miss Obstetrical Events at a Tertiary Care Centre at Madhya Pradesh

Abstract

Background: Maternal mortality is the major indicator used to monitor maternal health. For every women, who dies, however, many suffer serious life threatening complications of pregnancy. Yet relatively little attention has been given to identifying a general category of morbidities that could be called near misses. Characterising near miss morbidity is valuable for monitoring the quality of hospital based case and for assessing incidence of life-threatening complications. Besides mortality data, the identication and accurate documentation of "near-miss" morbidity (a more sensitive index) is extremely important to assess the quality of health care systems. It can suitably guide to adopt appropriate measures to reduce maternal mortality and morbidity. Methods: A cross sectional observational study was conducted in department of obstetrics and gynecology, MGM medical college Indore (M.P.) over apeiod of 2 years. Out of all obstetric inpatients cases of near miss were taken, identied by WHO 2009 criteria. In all cases the demographic characteristics, frequency of near miss in each criteria, direct and indirect obstetric causes of maternal morbidity & mortality were noted .This study was approved by institutional ethical committee. The data was recorded in predesign coded case report form and statistical analysis was performed using the STATA12.1. Result: in the present study incidence of Near miss was 65.6, Maternal mortality ratio=558(2017) 590(2018) per 1 lakh live birth and Near miss to maternal death ratio was 11.4 Severe maternal outcome ratio=71.3 per 1000 live birth Conclusion: Maternal near miss reviews provide evidence of where the main problem in overcoming maternal mortality and morbidity may lie, and analysis can be done in practical terms and highlight the key areas requiring recommendations for health sector and community action as well as guidelines for improving clinical outcomes.