scholarly journals Maternal near-miss and mortality associated with hypertensive disorders of pregnancy remote from term: A multicenter observational study in Ghana

2022 ◽  
pp. 100045
Author(s):  
Katja CE DRECHSEL ◽  
Kwame ADU-BONSAFFOH ◽  
Klaartje M OLDE LOOHUIS ◽  
Emmanuel K SROFENYOH ◽  
Daniel BOATENG ◽  
...  
Keyword(s):  
Observational Study ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Hypertensive Disorders Of Pregnancy ◽  
Multicenter Observational Study ◽  
Hypertensive Disorders

scholarly journals Maternal Near Miss Events in Tertiary Care Hospital: A Retrospective Observational Study

2021 ◽  
Author(s):  
Sonali J Ingole ◽  
Shilpa N Chaudhary
Keyword(s):  
Observational Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Care Hospital ◽  
Hypertensive Disorders ◽  
Obstetric Haemorrhage ◽  
In Pregnancy

Introduction: Over the years, continuous efforts have been made for improving reproductive health status of women. In India, Ministry of Health and Family Welfare (MoHFW) has set Maternal Near Miss (MNM) review operational guidelines. Aim: Analysis of the incidence and causes of MNM cases in tertiary care hospital. Materials and Methods: This retrospective observational study was undertaken at a tertiary care hospital from January 2010 to September 2018. MNM cases were identified according to the criteria given by MoHFW, MNM review operational guidelines. Following parameters (variables) were noted viz., age, parity, obstetric haemorrhage, severe anaemia, sepsis, therapeutic interventions, etc., and analysed. Quantitative data was analysed by calculating means, ratios and proportions, using SPSS software (Version 21.0). Results: There were total 36,366 deliveries during the study period. A total of 315 Maternal Near Miss cases were noted. Hypertensive disorders n=133 (42.2%) in pregnancy was the leading cause of MNM events at the hospital. This was followed by obstetric haemorrhage n =97 (30.79 %), and severe anaemia constituting n=36 (11.42%), and Sepsis n=30 (9.52%). Mortality index was highest in the sepsis group n=5 (14.28%) followed by severe anaemia n=3 (7.69%). Conclusion: Hypertensive disorders were most common cause of near miss cases followed by obstetric haemorrhage. Sepsis was commonest cause of maternal mortality. Early identification of hypertensive disorders in pregnancy, obstetric haemorrhage, severe anaemia and sepsis; and prompt treatment of these causes may help in reducing near miss and maternal mortality.

scholarly journals Why Some Mothers Could Be Saved and Not Others? Evaluating Different Phases of Delay in Causing Maternal Near Misses and Maternal Deaths

2020 ◽  
Author(s):  
Banashree Nath ◽  
Kashika Nagpal ◽  
Nandini Rajamani ◽  
Harsha S Gaikwad
Keyword(s):  
Quantitative Data ◽  
Poor Prognosis ◽  
Qualitative Data ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Hypertensive Disorders Of Pregnancy ◽  
Maternal Deaths ◽  
Sequence Of Events ◽  
Hypertensive Disorders ◽  
Significant Difference

Introduction: The factors playing key role in determining death and survival among the Maternal Mortality (MM) and Maternal Near Miss (MNM) cases are multidetermined and interdependent. It ranges from initial illness to perception of patients to seek healthcare services and initiation of management at primary health care settings. Aim: To evaluate the factors responsible for causing delay at different phases and thereby assess the key determinants of survival and death of mothers. Materials and Methods: This cross-sectional observational study was undertaken at the tertiary care centre and teaching hospital in northern India from October 2015 to December 2016. Study population consisted of all women who were identified as MNM and MM which occurred at Centre. Attendants accompanying the patient, mostly nearest kin who were able to give details of her health were questioned. Details regarding the sequence of events that caused her severe morbidity were taken right from recognition of morbid status to landing up in the tertiary setup. Approximate duration of delay for each case of MNM and MM was assessed. Any delays in accessing or receiving medical care were recorded, if available. Data Entry was done on MicroSoft Excel spreadsheet. Proportions were calculated for qualitative data. Mean score with confidence interval was calculated for quantitative data. Qualitative data was analysed by Chi-Square test and t-test was applied for quantitative data. Results: Out of 31,111 live births during the study period, there were 249 maternal near miss cases and 131 maternal deaths. Delay in women seeking help was observed in a total of 92.36% of cases in MNM group and 97.70% of cases in MM group (p=0.034). The study discovered significant differences when referral status (p=0.4904) as well as when number of referrals (p=0.041) were considered. There was a significant difference between the women of the two groups who reported only first phase delay (p=0.033). The major pregnancy related morbidities were haemorrhage and hypertensive disorders of pregnancy. Patients with hypertensive disorders of pregnancy with delay more than 12 hours survived the acute insult but were unable to cope with dysfunction of multiple organs and passed on after prolonged intensive care whereas in cases of Postpartum Haemorrhage (PPH), delay >6 hours were observed with extremely poor prognosis. Conclusion: Delay in taking decisions to seek healthcare is a major cause of MM. There is a little difference in outcome in terms of survival and death of mothers with delay in any of three phases despite increased intervention taken in adequate referral facilities. Precious time lost in deferral and referral contributes immensely to poor prognosis of mothers as compared to direct referral to an adequate health facility.

scholarly journals Severe Hypertensive Disorders of Pregnancy in Eastern Ethiopia: Comparing the Original WHO and Adapted sub-Saharan African Maternal Near-Miss Criteria

2020 ◽  
Vol Volume 12 ◽  
pp. 255-263
Author(s):  
Abera Kenay Tura ◽  
Sicco Scherjon ◽  
Jelle Stekelenburg ◽  
Jos van Roosmalen ◽  
Thomas van den Akker ◽  
...  
Keyword(s):  
Near Miss ◽  
Maternal Near Miss ◽  
Hypertensive Disorders Of Pregnancy ◽  
Eastern Ethiopia ◽  
Hypertensive Disorders ◽  
Sub Saharan

scholarly journals Hypertension in Pregnancy Still Remains a Serious Complication Causing Severe Morbidity and Mortality of Mother

2016 ◽  
Vol 30 (2) ◽  
pp. 92-97
Author(s):  
Arife Simsek ◽  
Seyfettin Uludag ◽  
Ali Benian ◽  
Abdullah Tuten
Keyword(s):  
Maternal Mortality ◽  
Care Center ◽  
Tertiary Care ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Maternal Deaths ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Mortality Index ◽  
Retrospective Examination

Objective(s): The aim of this study is to evaluate frequency and nature of maternal deaths and maternal near-miss cases in a tertiary care hospital.Materials and Methods: A retrospective examination was conducted on records of the16.612 women who delivered in a tertiary care center, over a ten-year period (1997-2006). The flow chart recommended by Say et al was used in the analysis of the maternal near-miss cases.Results: The ratios of mortality related with pregnancy, maternal mortality and maternal nearmiss were 68.11/100.000, 61.29/100.000 and 17.09/1000, respectively. The ratio of maternal near- miss to maternal mortality was 27.8 and the mortality index was 3.46%. Hypertensive disorders were the leading cause of maternal deaths and maternal near-miss events.Conclusion: Hypertensive disorders were still leading cause of maternal deaths and maternal near-miss events.Absence of antenatal care and disrupted referral chains were major problems.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 92-97

scholarly journals Evaluation of associated risk factors of near miss obstetrics cases at B.P. Koirala Institute of Health Sciences, Dharan, Nepal

2018 ◽  
Vol 7 (2) ◽  
pp. 408
Author(s):  
Madan Khadka ◽  
Dhruba Kumar Uprety ◽  
Rubina Rai
Keyword(s):  
Risk Factors ◽  
Maternal Death ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Care Hospital ◽  
Hypertensive Disorders ◽  
Life Threatening ◽  
Associated Risk Factors ◽  
Surgical Condition ◽  
Ruptured Uterus

Background: In 2011, around 273,465 women died worldwide during pregnancy, childbirth or within 42 days after childbirth. Near-miss is recognized as the predictor of level of care and maternal death. The objective of the study was to evaluate the associated risk factors of near miss obstetric cases.Methods: A prospective observational study was done from August 1, 2014 to July 30, 2015 in Department of Obstetrics and Gynecology at BPKIHS hospital, tertiary care hospital in Eastern Nepal, Dharan. Case eligible by 5 factor scoring system and WHO near miss criteria were evaluated. Risk factors included severe hemorrhage, hypertensive disorders, complication of abortion, ruptured uterus, medical/surgical condition and sepsis.Results: A total of 9,727 delivery were attended during the study period from August 2014 to July 2014. There were 6307 (71.5%) vaginal delivery and 2777 (28.5%) caesarean section and 181 perinatal death with total of 9,546 livebirth. 162 near miss and 16 maternal death occurred during the study. Maternal near miss rate of 16.6 per 1000 live birth, Women with life-threatening conditions of 172, Severe maternal outcome ratio of 18.64, Maternal near-miss: mortality ratio: 10.1:1, Mortality index: 8.98%. Risk factors were obstetric hemorrhage 27.8%, abortion/ectopic 27.2%, eclampsia 16%, medical/surgical condition 14.8%, sepsis 13.6%, severe preeclamsia 11.1%, ruptured uterus 3.1%, and molar pregnancy 1.9% and cardiovascular and coagulation dysfunction as a major life-threatening condition and sepsis (25%) was the major cause of mortality.Conclusions: Haemorrhage and hypertensive disorders are the leading causes of near miss event. Evaluation of associated risk factor can be potential tool for reduction of maternal morbity and mortality.

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