Clinical Spectrum of Near-miss Cases in Obstetrics

Abstract

Introduction Near-miss obstetric cases are the ones which have survived childbirth after a life-threatening and complicated pregnancy. The aim of this study is to evaluate important characteristics and causes of near-miss cases, compare them with maternal deaths, and assess urgent interventions managing these patients. Materials and methods This prospective, cross-sectional study was conducted in the intensive care unit of the Obstetrics and Gynecology department. Clinical spectrum of near-miss patients was compared with that of maternal deaths. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) Statistics for Windows, version 21.0 (IBM Corp., Armonk, NY). Results The incidence of near-miss events was 31.4/1,000 live births. The incidence of maternal mortality was 8.2/1,000 live births. The ratio of near-miss to maternal mortality was 3.8:1. Hemorrhage, hypertensive disorders, and puerperal sepsis were the leading causes of near-miss cases. Conclusion Evaluation of characteristics of near-miss cases helps in establishing severe maternal morbidity. These high-risk patients must be provided urgent interventions to prevent maternal mortality.

Analysis of Extreme Maternal Morbidity at the Women´s Hospital of Aguascalientes

“…Another individual determinant for obstetric risk to consider is parity. Most authors suggest that multiparity is a risk factor for extreme maternal morbidity [26][27][28]. Although, there are authors who state that first time pregnancy is also a risk factor associated with this condition [29], we found no significant difference between history of being multiparous and primiparous for the development of an extreme maternal morbidity event ( X 2 =0.05, p= 0.9).…”

Maternal near miss: Unraveling our experience in the tertiary care hospital of Andaman and Nicobar Islands

“…Table 4 highlights the comparison of MNM indicators from various studies. [ 9 10 11 12 13 14 ]…”

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

“…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. Other studies done by Chikadaya et al [ 13 ] in Zimbabwe and by Dessalegn et al [ 14 ] in Ethiopia showed the most common cause of a near-miss as hemorrhage and hypertensive disorder in pregnancy followed by early pregnancy complications.…”