scholarly journals Obstetric near miss events and maternal deaths in a tertiary care hospital

2018 ◽  
Vol 7 (2) ◽  
pp. 519
Author(s):  
Vrinda Patil ◽  
Vidya Kamath ◽  
Rathnamala M. Desai
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Mortality Ratio ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Mortality Index ◽  
Mortality Ratio ◽  
Life Threatening

Background: Maternal mortality is one of the important indicators of maternal health. Objectives of present study were to determine the frequency of maternal near miss, maternal near miss incidence ratio, maternal near miss to mortality ratio and mortality index and to study the risk factors associated with near miss events.Methods: A retrospective analysis of severe maternal morbidity from January 2015 to December 2015 was studied. Data was collected from women with pregnancy related life-threatening complications, near miss cases and maternal deaths.Results: The total number of deliveries were 5247. The numbers of maternal deaths were 12. Maternal mortality ratio was 228 per one lakh deliveries. There were 5.3 near miss events for every 1 maternal death. The nature and course of near miss cases were analysed. Severe maternal odds ratio was 14.48. Mortality index was 15.78%. Maternal near miss incidence ratio was 12.19.Conclusions: Near Miss Mortality indicator is helpful in identifying the life-threatening conditions and thus aiming to prevent maternal mortality. Hypertensive disorders and its complications are the leading causes of near miss events. Sepsis is the main cause of maternal death.

scholarly journals “Near Miss” Obstetric Events and Maternal Deaths in a Tertiary Care Hospital: An Audit

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Roopa PS ◽  
Shailja Verma ◽  
Lavanya Rai ◽  
Pratap Kumar ◽  
Murlidhar V. Pai ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Live Births ◽  
Hypertensive Disorders ◽  
Mortality Index ◽  
Mortality Ratio

Objectives. (1) To determine the frequency of maternal near miss, maternal near miss incidence ratio (MNMR), maternal near miss to mortality ratio and mortality index. (2) To compare the nature of near miss events with that of maternal mortality. (3) To see the trend of near miss events.Design. Audit.Setting. Kasturba Hospital, Manipal University, Manipal, India.Population. Near miss cases & maternal deaths.Methods. Cases were defined based on WHO criteria 2009.Main Outcome Measures. Severe acute maternal morbidity and maternal deaths.Results. There were 7390 deliveries and 131 “near miss” cases during the study period. The Maternal near miss incidence ratio was 17.8/1000 live births, maternal near miss to mortality ratio was 5.6 : 1, and mortality index was 14.9%. A total of 126 cases were referred, while 5 cases were booked at our hospital. Hemorrhage was the leading cause (44.2%), followed by hypertensive disorders (23.6%) and sepsis (16.3%). Maternal mortality ratio (MMR) was 313/100000 live births.Conclusion. Hemorrhage and hypertensive disorders are the leading causes of near miss events. New-onset viral infections have emerged as the leading cause of maternal mortality. As near miss analysis indicates the quality of health care, it is worth presenting in national indices.

scholarly journals A study to assess proportion of the maternal near miss to maternal death in a tertiary care teaching hospital of North East India

2020 ◽  
Vol 9 (6) ◽  
pp. 2486
Author(s):  
Pradip Sarkar ◽  
Jahar Lal Baidya ◽  
Ashis Kumar Rakshit
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Maternal Deaths ◽  
Live Births ◽  
Medical Disorders ◽  
Mortality Ratio

Background: The objective of present study was to assess the proportion of maternal near miss and maternal death and the causes involved among patients attending obstetrics and gynaecology department of Agartala Govt. Medical College of North Eastern India.Methods: Potentially life-threatening conditions were diagnosed, and those cases which met WHO 2009 criteria for near miss were selected. Maternal mortality during the same period was also analyzed. Patient characteristics including age, parity, gestational age at admission, booked, mode of delivery, ICU admission, duration of ICU stay, total hospital stay and surgical intervention to save the life of mother were considered. Patients were categorized by final diagnosis with respect to hemorrhage, hypertension, sepsis, dystocia (direct causes) anemia, thrombocytopenia, and other medical disorders were considered as indirect causes contributing to maternal near miss and deaths.Results: The total number of live births during the study period (January 2017 to June, 2018) was 9378 and total maternal deaths were 37 with a maternal mortality ratio of 394.5/1 lakh live births. Total near miss cases were 96 with a maternal near miss ratio of 10.24/1000 live births. Maternal near miss to mortality ratio was 2.6. Of the 96 maternal near miss cases - importantly 20.8% were due to haemorrhage, 19.8% were due to hypertension, 13.5% were due to sepsis, and 11.5% were due to ruptured uterus. In maternal death group (n-37), most important causes were hypertensive (40.5%) followed by septicemia (21.6%), haemorrhage (10.8).Conclusions: Haemorrhage, hypertensive disorders and sepsis were the leading causes of near miss events as well as maternal deaths.

scholarly journals Severe Life-Threatening Pregnancy Complications, “Near Miss” and Maternal Mortality in a Tertiary Hospital in Southern Nigeria: A Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Ubong Bassey Akpan ◽  
Udeme Asibong ◽  
Ezukwa Omoronyia ◽  
Kazeem Arogundade ◽  
Thomas Agan ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Pregnancy Complications ◽  
Maternal Mortality Ratio ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Infant Survival ◽  
Maternal Deaths ◽  
Live Births ◽  
Mortality Ratio ◽  
Life Threatening

Background. Investigating severe life-threatening pregnancy complications that women encounter and the maternal morbidities (near miss) may help to evaluate the quality of care in health facility and recommend ways to improve maternal and infant survival especially in low-income countries. The aim of this review was to identify, classify, and determine the frequency and nature of maternal near miss events and the maternal and perinatal outcomes. Methods. A retrospective facility-based review of cases of near miss and maternal mortality occurring between 1st January 2012 and 31st December 2016 at the University of Calabar Teaching Hospital was conducted. Near miss case definition was based on the WHO disease specific criteria. The main outcomes included the maternal mortality ratio (MMR), maternal near miss ratio (MNMR), mortality index, maternal morbidities, and perinatal outcome. Results. There were 10,111 pregnancy-related admissions, 790 life-threatening pregnancy complications that resulted in 99 maternal deaths, and 691 near miss cases. The maternal mortality ratio was 979 maternal deaths per 100,000 live births, and the maternal near miss ratio was 6,834 per 100,000 maternities. The MMR to MNMR ratio was 1 : 8. Sepsis and severe anaemia had high case-specific mortality indices of 0.4 and 0.53, respectively. The perinatal outcome was poor compared to that of uncomplicated pregnancies: perinatal mortality rate (PMR) 266 per 1000 live births (OR 7.74); neonatal intensive care (NIC) admissions 11.6 percent (OR 1.83); and low birth weight (LBW) (<2.5 kg) 12.19 percent (OR 1.89). Conclusion. Antenatal care and early recognition of danger signs in pregnancy as well as prompt referral and early institution of essential obstetrics care are important for maternal and infant survival.

scholarly journals A Prospective Observational Study of Near-miss Events and Maternal Deaths in Obstetrics

2016 ◽  
Vol 8 (4) ◽  
pp. 261-265
Author(s):  
Smiti Nanda ◽  
Shaveta Yadav
Keyword(s):  
Observational Study ◽  
Maternal Mortality ◽  
Prospective Observational Study ◽  
Maternal Mortality Ratio ◽  
Near Miss ◽  
Maternal Deaths ◽  
Live Births ◽  
Mortality Index ◽  
Severe Maternal Outcome ◽  
Mortality Ratio

ABSTRACT Purpose To study the incidence and causes of near-miss cases and maternal deaths (MDs) and also search the level of delay. Materials and methods The prospective observational study was carried out in the Department of Obstetrics and Gynecology for a period of one and a half year (September 2012 to February 2014). For identifying near-miss events, disease-specific criteria were used. Near-miss cases were identified among women with pregnancy-related complications whose diagnoses were meeting the criteria. Detailed information of maternal mortalities and near-miss cases for demographic features, underlying causes, treatment received, and level of delay were also obtained. Results There were 15,170 obstetric admission, 13,851 live births, 184 near-miss cases, and 60 MDs during the study period. The maternal near-miss (MNM) rate was 13.2/1,000 live births and maternal mortality ratio was 433.1/100,000 live births. The mortality index (MD/MNM+MD) was reported as 25%. The maternal mortality to near-miss ratio was 1:3.07. Severe maternal outcome rate (MNM/MNM+MD) was 17.6/1,000 live births. Hemorrhage (54.89%) was the leading cause of nearmiss events followed by hypertension (24.45%) and anemia (13.59%). Hypertension (26.66%) was responsible for most of the MDs followed by anemia (25%), hemorrhage (20%), and puerperal sepsis (10%). The most common level of delay was found on the part of women and/or family to seek help. Conclusion Hypertension, hemorrhage, and anemia are leading causes of maternal morbidity and mortality. Lessons need to be learnt from cases of near-miss, which can serve as a useful tool in making strategies and putting efforts to reduce maternal mortality. How to cite this article Yadav S, Nanda S. A Prospective Observational Study of Near-miss Events and Maternal Deaths in Obstetrics. J South Asian Feder Obst Gynae 2016;8(4):261-265.

scholarly journals EVALUATION OF OBSTETRIC NEAR MISS & MATERNAL DEATHS IN A TERTIARY CARE TEACHING HOSPITAL

2021 ◽  
pp. 1-2
Author(s):  
B. Harika ◽  
Bhavishya Gollapalli
Keyword(s):  
Health Care ◽  
Maternal Mortality ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Maternal Health Services ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Maternal Deaths ◽  
Mortality Ratio

Background: Maternal Mortality is a critical indicator to assess the quality of services provided by a health care system.The concept of severe acute maternal morbidity (SAMM) has been found to complement the assessment of maternal health services, since pregnant women’s health status is not reflected by mortality indicators alone . Maternal near miss cases are more common than maternal deaths. Methods: A Retrospective analysis of maternal near miss cases and maternal deaths was undertaken in the Department of Obstetrics and Gynaecology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh over a period of two years. This study was conducted to find out maternal near miss and maternal deaths. Results: There were 2000 deliveries, 66 MNM cases and 2 maternal deaths during the study period. The Maternal Near Miss Incidence Ratio (MNMIR) ratio was 33%.The maternal near miss to mortality ratio was 33% for each maternal death. The Maternal Mortality Ratio (MMR) was 100 per 1 lakh live births in our study. Conclusion: We suggest near miss approach to evaluate and improve the quality of care provided by the health care system. By reviewing the near miss cases we can learn about the processes and their deficiencies that are in place for the care of pregnant women.

scholarly journals Maternal Death Reviews of a Tertiary Care Hospital

2014 ◽  
Vol 52 (193) ◽  
pp. 713-718
Author(s):  
Indira Upadhyaya
Keyword(s):  
Maternal Mortality ◽  
Older Women ◽  
Maternal Death ◽  
Medical Records ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Mortality Ratio

Introduction: All pregnant women are at risk of obstetrical complications which occurs during labour and delivary that lead to maternal death. Here to report a 10 year review of maternal mortality ratio in "Paropakar Maternity and Women's Hospital (PMWH)" Thapathali  Kathmandu, Nepal.Methods: Medical records of 66 maternal deaths were reviewed to study the likely cause of each death over the study period.Results: There were a total of 66 maternal deaths. While 192487 deliveries conducted over the 10 year period. The maternal mortality ratio (MMR) was 356.64/100000 live birth. The highest MMR of 74.22/100,000 was observed in 2059 and lowest was 17.42/100,000 in 2068 B.S. Leading cause of MMR was remained hemorrhage accounting for 30.30% followed by eclampsia 24.24%. Sepsis, suspected cases of pulmonary embolism and amniotic fluid embolism each contributing 15.15%, 4.54% and 3.03% respectively. Where as anesthetic complication and  abortion constiuates 6.06 % each equally for maternal death. The death noted in older women (30+year) were 36.36%. Primipara accounted for more deaths (51.51%).Conclusions: The fall in maternal mortality rate has been observed except for year 2063 BS.  Haemorrhage is the main contributing cause behind maternal mortality.

scholarly journals PREVALENCE OF NEAR MISS AND MATERNAL DEATHS AND ITS MATERNAL AND PERINATAL OUTCOMES: A RETROSPECTIVE STUDY

2021 ◽  
pp. 62-65
Author(s):  
ANITA MADAN ◽  
PALLAVI SHARMA ◽  
JAGDEEP KAUR ◽  
ANISHA PURI
Keyword(s):  
Cesarean Section ◽  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Perinatal Outcomes ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Maternal Deaths ◽  
Emergency Cesarean ◽  
Tertiary Teaching ◽  
Mortality Ratio

Objectives: The objective of the study was to determine maternal mortality ratio (MMR), maternal near miss incidence ratio (MNM IR), MNM to mortality ratio (MNM: MD), and mortality index (MI) and to know the prevalence, demographic distribution, causes and feto-maternal outcome of maternal near miss and maternal deaths. Methods: A retrospective review of near miss and maternal mortality over a period of 20 months in a tertiary teaching hospital in Punjab. Results: MMR was 998 MNM IR was 24.20/1000 live births. Maternal near miss mortality ratio was 2.4:1. MI was 29.21%. The most common cause of maternal mortality was hypertension, which was seen in 14 (53.84%) women. Among near miss cases, the most common complication noted was hemorrhage, seen in 40 (63.49%) cases. Among maternal deaths, 7 (26.92%) women delivered vaginally, 6 (23.07%) women underwent emergency cesarean section. Among near miss cases, 20 (31.74%) women delivered vaginally, 13 (20.63%) women underwent cesarean section while 7 (11.11%) had cesarean hysterectomy. Laparotomy for ruptured ectopic pregnancy was done in 6 (9.52%) women, 7 (11.11%) women had dilatation and evacuation, 3 (4.76%) had exploration of Uterovaginal canal. Preterm birth has seen in 8 (12.69%) in maternal deaths and 23(36.50%) in maternal near miss. Intrauterine fetal demise occurred in 4 (6.34%) in maternal deaths and 2 (4.87%) in near miss. Conclusion: The review of near miss cases is important to identify response of health care system to medical emergencies and provides opportunities to improve the quality of service.

scholarly journals Two year review of maternal mortality at a tertiary care hospital of GMERS, Valsad, Gujarat, India

2018 ◽  
Vol 7 (6) ◽  
pp. 2283
Author(s):  
Darshna M. Patel ◽  
Mahesh M. Patel ◽  
Vandita K. Salat
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Rural Areas ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Mortality Ratio

Background: According to the WHO, 80 of maternal deaths in developing countries are due to direct maternal causes such as haemorrhage, hypertensive disorders and sepsis. These deaths are largely preventable. Maternal mortality ratio (MMR) in India is 167/100,000 live births.Methods: This retrospective observational study was conducted at GMERS, Valsad. Data regarding maternal deaths from January 2016 to December 2017 were collected and analyzed with respect to epidemiological parameters. The number of live births in the same period was obtained from the labour ward ragister. Maternal mortality rate and Mean maternal mortality ratio for the study period was calculated.Results: The mean Maternal mortality rate in the study period was 413.3/100,000 births. The maternal mortality ratio (MMR) in India is 167/100,000 live births. More than half of maternal deaths were reported in multiparous patients. More maternal deaths were observed in women from rural areas (67.3%), unbooked patients (73.3%) and illiterate women (65.3%). Thirty six (69.3%) maternal death occurred during postpartum period. Most common delay was first delay (60.0%) followed by second delay (40.0%). Postpartum haemorrhage (28.8%), preeclampsia (17.3%), sepsis (13.46%) were the major direct causes of maternal deaths. Indirect causes accounted for one third of maternal deaths in our study. Anemia, hepatitis and heart disease were responsible for 13.4%, 5.7%, and 1.9% of maternal deaths, respectively.Conclusions: Majority of maternal deaths are observed in patients from rural areas, unbooked, and illiterate patients. Hemorrhage, eclampsia and sepsis are leading causes of maternal deaths. Most of these maternal deaths are preventable if patients are given appropriate treatment at periphery and timely referred to higher centers.

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 Maternal mortality-a three-year retrospective study in a rural medical college of India

2021 ◽  
Vol 10 (8) ◽  
pp. 3019
Author(s):  
Jayasree Hansda ◽  
Debobroto Roy ◽  
Krishnapada Das ◽  
Manojit Sarkar ◽  
Rumpa Das ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Tertiary Care Centre ◽  
Maternal Deaths ◽  
Demographic Profiles ◽  
Medical College ◽  
Mortality Ratio ◽  
Tragic Event

Background: Maternal mortality is a tragic event as family revolves around a mother. The deadly obstetrical triad of hemorrhage, preeclampsia and infection has accounted for a third of all deaths. This study was conducted to assess maternal mortality ratio, demographic profile and causes of maternal death.Methods: This retrospective longitudinal study was conducted in the department of obstetrics and gynecology for a period of three years from 1st January 2018-31st December, 2020. Total no of death during this period was 134.Records of deaths and demographic profiles were retrieved from the medical record library of aforesaid hospital.Results: There were 134 maternal deaths amongst 56815 live births with MMR 235.85. The majority of deaths were in 20-29 year of age group and most of the deaths seen in multigravida. The 91.79% death was observed within the 24 hours and after 72 hours. Eclampsia, preeclampsia and hemorrhage were leading cause of maternal death seen in the study.Conclusions: Maternal mortality is higher than national MMR. Majority of maternal death were preventable by proper antenatal care, early detection of high-risk pregnancies and their timely referral to tertiary care centre.

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