Maternal near miss review from a tertiary care center in South India

Chandran, Jyoti Ramesh; Raj, Sajala Vimal; Devi, D Sumangala; Ramachandran, Anand

doi:10.18203/2320-1770.ijrcog20162640

Cited by 6 publications

(12 citation statements)

References 4 publications

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“…Strict maternal surveillance with more frequent BP check-ups and urine examination for albuminuria have to be strictly adhered to for early detection of pre-eclampsia. These three are the leading causes of near miss in some of the Indian studies also, 11,12,15 and one study from Rwanda.…”

Section: Discussionmentioning

confidence: 99%

“…2 Even though studies have been done in Rajasthan, Kozhikode (Kerala), India and other parts of the country, with an ongoing confidential review of maternal death in the state of Kerala. 7,11,12 This study setting, Government medical college Thiruvananthapuram could come out with only a limited number of studies. This study aims to analyse the near miss events and mortality events which occurred in the study setting from January 2011 to December 2012, to compare the causes that led to the events and to analyse the quality of care given to mothers This study also helps to analyse the pattern of referral, what all modification, can be made at FRU level for better patient survival.…”

Section: Introductionmentioning

confidence: 99%

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Burden and causes of maternal mortality and near-miss in a tertiary care centre of Kerala, India

Umadevi

Ayesha

Radha

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Reduction of maternal mortality remains a challenge for developing countries like India as per the sustainable development goals put forward by UN. Near-miss audit is emerging as a new tool for setting new protocols in reduction of MMR. This study aimed, to analyze the near miss events and mortality events which occurred in the study setting from January 2011 to December 2012, and to compare the causes that led to the events.Methods: A descriptive comparative study was conducted at SAT Hospital, Government Medical College, Thiruvananthapuram, a tertiary care center in Kerala, India on the data accounted for a period of 2 years, 2011 and 2012. Maternal near-miss during the period is studied according to WHO 2009 criteria and compared with the maternal deaths during the same time period. The data was recorded using structured proforma; the same proforma was used to record maternal mortality cases of the same period.Results: Total live births during the time period were 18,663. Eighty-eight near miss cases and 26 maternal deaths occurred during the study period. Incidence proportion of maternal near-miss was 4.71/1000 live births. Severe maternal outcome was 6 per1000. For every maternal death, there were 3.38 near-misses. Mortality index of our institute was 22.8% and maternal mortality ratio (MMR) of the study setting was 139/1 Lakh live births. Post-partum hemorrhage was the leading cause for near-miss and systemic diseases were the major contributors to mortality.Conclusions: It is evident from the present study that PPH, once the leading cause of maternal mortality is now the leading cause of maternal near miss and by improving the resources of FRUs it can be further reduced. Systemic diseases are emerging as a new threat to the obstetric population leading to mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Burden and causes of maternal mortality and near-miss in a tertiary care centre of Kerala, India

Umadevi

Ayesha

Radha

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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“…This agrees with MMR of Kozhikode (153) and that of India (130). 4,6 This is less than that reported from Selem, New Delhi and Bangladesh. [7][8][9] This is much higher than that in developed nations and that of Kerala (46).…”

Section: Discussionmentioning

confidence: 69%

Trends in causes of maternal mortality in a tertiary care centre in Kerala, India

Sreekumari

Nair

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Kerala has the lowest maternal mortality ratio compared to other Indian states. But when compared to developed countries Kerala has still a long way to go. The present study aimed to analyse the causes of maternal deaths that occurred in the study setting for a period of seven years (2011-2017).Methods: Retrospective study which was conducted at SAT hospital, Govt. Medical College, Thiruvananthapuram. All maternal deaths that occurred in the study setting from January 2011 to December 2017 were found out from registers. The baseline socio demographic characteristics, gravidity, parity, cause of death were recorded using structured proforma and analyzed using SPSS software.Results: Total maternal deaths during the time period was 101. There were 66441 live births. Maternal mortality ratio for the seven-year period was 152. Majority were primigravidae (50.49%), of low socio-economic status (79.2%), rural population (81.1%) and referred from periphery after identifying complication (85.1%). Caessarean section was the commonest mode of delivery among them (43.56%). Regarding cause of death, indirect maternal deaths were more than direct deaths (50.49% versus 42.57%). Cardiac disorder was the leading indirect cause (12.87%), Post-partum hemorrhage (13.86%), Hypertensive disorders (8.91%) and Sepsis (7.9%) were the leading direct causes.Conclusions: Early referral protocols, increasing blood and blood component availability in the periphery should be reinforced. Regarding indirect causes medical boards should be constituted in tertiary care centres for prompt and efficient multidisciplinary care.

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“…Uterine aonicity leading to massive blood loss is responsible for the majority of primary PPH 15,17,18,20 . Present study also agrees to this observation.…”

Section: Resultsmentioning

confidence: 99%

The Burden of Major Obstetric Hemorrhage in Near Miss in a Tertiary Care Centre in Kerala

Umadevi¹

2017

jmscr

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Maternal near miss review from a tertiary care center in South India

Cited by 6 publications

References 4 publications

Burden and causes of maternal mortality and near-miss in a tertiary care centre of Kerala, India

Burden and causes of maternal mortality and near-miss in a tertiary care centre of Kerala, India

Trends in causes of maternal mortality in a tertiary care centre in Kerala, India

The Burden of Major Obstetric Hemorrhage in Near Miss in a Tertiary Care Centre in Kerala

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