Incidence of maternal near miss and mortality cases in central India tertiary care centre and evaluation of various causes

Abstract

Background: Analysis of maternal near miss provides a good opportunity for assessing the factors responsible for maternal mortality in this area. Objective: Incidence of maternal near miss and mortality cases in central India tertiary care centre and evaluation of various causes using WHO criteria. Material and Methods: It is an ongoing prospective observational study conducted in the department of Obstetrics and Gynaecology, Index medical college, Indore, MP from September 2015 to October 2016. The patients who fulfilled the WHO criteria of maternal near miss were enrolled; their clinical and investigation parameters were recorded. Results: During the study period a total 4786 deliveries were observed, out of that 4533 were live births, 74 were near miss cases and 15 maternal deaths. Twenty nine (39.1%) of near miss cases were found in 15-20 year of age group while 53.33 % cases of maternal death were found of same age group. Primipara cases were more in both near miss (60.8 %) and maternal death group (60.0 %). Majority of patients were in third trimester and underwent vaginal delivery. Among the causes of near miss events, hemorrhage was the leading cause followed by preeclampsia/eclampsia and sepsis. Conclusion: Near miss cases generally occur more frequently than maternal death and therefore a more reliable quantitative analysis can be carried out, which can provide more comprehensive profile of health system functioning. Identification of the obstacles and gaps in the health system and a coordinated approach to resolve these can ultimately lead to an improved health system.

Prevalence and Associated Factors with Maternal Near-Miss among Pregnant Women at Hawassa University Comprehensive Specialized Hospital, Sidama Region, Ethiopia

“…This study was almost in line with finding from global reported 15% and Sub-Sahara countries 12.2% respectively [2,16]. However, it is higher than the report in India at 1.6%, Bangladesh 2%, Brazil 0.5%, Ghana 3%, and Southwestern Nigeria at 1.8% [2,15,[17][18][19][20]. The current study is also higher than the study done in some parts of Ethiopia, Felege Hiwot…”

“…This study also revealed that almost half the underlying cause of maternal near-miss was due to hypertensive disorder of pregnancy and most maternal near-miss occurred before arrival to these hospitals. This study is similar tothe study done in India, Nigeria, Addis Ababa Specialized Hospital, and southern Ethiopia [17,21,22,25]. In the current study, the rural residence was one of the significantly associated factors for associated with maternal near-miss.…”

Implementing the Who Near Miss Model to Assess Quality of Obstetric Care in a Tertiary Care Hospital

“…The proportion of primigravidas was more in our study which is comparable with the results of Gupta D et al 18 who also found primipara women more in both near miss and maternal death groups . Our results were not comparable with the study of Chandrakanta Prasad et al 19 who noted among maternal near-miss, the majority of women were multiparity which is comparable to Bansal et al 20 Our findings were similar results to Waterstone et al 21 and Morse et al 22 regarding the period of gestation>36 weeks in maternal near miss cases near miss Maternal mortality ratio (MMR) has been used by healthcare planners as a yardstick to assess the quality of obstetric services in an area.…”

Maternal Near-Miss as a Surrogate Indicator of the Quality of Obstetric Care: A Study in a Tertiary Care Hospital in Eastern India

“…Both MNMR and SMOR give an estimate of the amount of care and resources that would be needed to improve obstetric care in that area or facility. We reviewed studies done in different parts of India, and the near-miss ratio ranged from 120 to 10.4 ( Table 12) [10][11][12][13][14][15][16][17][18][19][20][21][22]. However, all these studies have used different criteria in identifying near-miss cases and hence technically not ideal for comparison.…”