A study on maternal near miss cases in Government Medical College Shivpuri, India

Abstract

Background: Obstetrics near miss is an important indicator that reflects the quality of obstetrics care in a health facility. It assesses and monitors the activities aimed for prevention of maternal mortality. The aim and objective of this study was to find out the incidence, the prevalence and causes of maternal near miss due to severe obstetric complications and to identify the gapes and contextualize corrective measures to be taken in our facility.Methods: This is a retrospective study done in department of Obstetrics and Gynecology in GMC associated with DHS Shivpuri MP. The study was done during a period from 1st January 2018 to 30 April 2019.Results: In this study the hospital maternal near miss incidence ratio was 14.34%. In our study we found the most common morbidity was (30.18%) hypertensive disorder of pregnancy. These 159 near miss diagnoses were comprised of (30.18 %) cases of Hypertensive disorder of pregnancy, (27.67%) cases of major obstetric hemorrhage, (6.91) Severe systemic infection or sepsis, (4.40%) Labour related disorders. In Medical disorders very Severe Anemia, (1.88%) was most common cause of near miss. The most common cause of death was post-partum hemorrhage 37.5% and most of the patients referred from periphery in very critical condition. The median time taken to get clinical intervention among cases was 20-40 minutes after admission.Conclusions: Hemorrhage and hypertension disorders are the leading causes of MNM. Prompt diagnosis and adequate management of near miss cases can reduce mortality rates.

Prevalance and outcome of maternal near miss in a tertiary care centre a cross sectional study at Hassan, Karnataka, India

“…Syrian study showed a ratio of 60:1 [9,10] Anjali mali reported that Near miss death ratio was found to be 3.1:1 which means that for every three MNM women, one woman dies of complications. In the present study, near miss: death ratio was found somewhat similar to other studies, [5,14,17] while in some other states, it was found to be higher [4,13,16] Higher near miss mortality ratio indicates a better quality of care at that facility Maternal near miss rate was 2.12/1000 deliveries, Maternal mortality index is 20.9 which was less when compared to a study by Bansal M et al [11] . During the study period 09 patients died, out of which 03 patients died due to severe anemia, 02 due to cardiac conditions.…”

“…Twenty-seven (84.4%) women required hospitalization for a week or more. In present study, Out of 15,977 births, near miss cases were 34(2.2%), among them term babies were 22(64.7% ), preterm 01(5.8%), IUFD were 06(17.6%), others were ectopic pregnancy and abortions ad mean duration of hospital stay was 7.4 days [11][12][13][14]16].…”

“Near-Miss” Obstetric Events and Maternal Deaths in a Rural Tertiary Care Center in North India

“…This may be because our center is in a rural area and covers most of the referral centers in these areas. Another study by Jain [ 8 ] in 2019 in Shivpuri, Madhya Pradesh, shows an MNM incidence ratio of 14.3, which was almost similar to that found in our study. Studies conducted in other countries, like in Nigeria by Akpan et al [ 9 ], also showed a near-miss incidence ratio of 68.3/1000 live births and maternal near-miss ratio (MNMR):MMR of 1:8, which was higher than found in our study and showed better quality of health care services at their center.…”

“…In this study, the age group of 20 to 35 years was most commonly affected both by MNM and maternal mortality due to the fact that it is the most common reproductive age group so mostly complications occur in this age group. It is similar to the study by Bansal et al [7] in Bastar, Chhattisgarh, in 2016, and Jain [8] in 2019 in Shivpuri, Madhya Pradesh.…”

“…The most common cause of a maternal near-miss was hypertensive disorder in this study, which was similar to the study done by Jain in 2019 [8] and the study by Mansuri et al [10] in Ahmadabad, Gujrat, in 2018, whereas the study by Bansal et al [7] in 2016 and Roopa et al [11] in 2013 showed hemorrhage as the most common SAMM followed by hypertensive disorders in pregnancy. Another study done by Sultana et al [12] in Karachi, Pakistan, showed hemorrhage, hypertensive disorder in pregnancy, and sepsis as the most common causes of near-miss events.…”