scholarly journals Incidence of maternal near-miss events in a tertiary care hospital of Gujarat, India

2019 ◽  
Vol 9 (1) ◽  
pp. 145
Author(s):  
Vijay Kansara ◽  
Disha Vaja ◽  
Ajesh Desai
Keyword(s):  
Tertiary Care ◽  
Institutional Care ◽  
Rare Event ◽  
Obstetric Care ◽  
Near Miss ◽  
World Health ◽  
Maternal Near Miss ◽  
Care Hospital ◽  
Cross Sectional ◽  
Life Threatening

Background: Maternal near miss is said to have occurred when women presented with life threatening complication during pregnancy, child birth and within 42 days after delivery, but survive by chance or good institutional care. For identifying near-miss cases five-factor scoring system was used. In 2009 WHO working group has standardized the criteria for selecting these cases. Because maternal mortality is a rare event, it is important to study maternal near-miss as a complement to evaluate and improve the quality of obstetric care. Thus, the study was conducted with the aim of assessing the incidence and causes of maternal near-miss.Methods: A facility-based cross-sectional study was conducted in the department of obstetrics and gynecology in GMERS medical college and hospital, Sola, Ahmedabad from January 1, 2019 to August 31, 2019. All maternal near-miss cases admitted to the hospital during the study period were recruited. World Health Organization criteria were used to identify maternal near-miss cases. The number of maternal near-miss cases over one year per 1000 live births occurring during the same year was calculated to determine the incidence of maternal near-miss. Underlying and contributing causes of maternal near-miss were documented from each participant’s record.Results: During the period of study, 3235 deliveries were done at the institution while 16 cases of near-miss were identified. The prevalence of near-miss case in this study was 0.5%. Near-miss per 1000 delivery was 5%. Maternal death to near miss ratio was 1:2.67. The leading causes of maternal near miss were hypertensive disorders (62%) and haemorrhage (32%) The morbidity was high in un-booked cases.Conclusions: Maternal near miss is good alternative indicator of health care system. Efforts made toward improvement in the management of life-threatening obstetric complications could reduce the occurrence of maternal near-miss problems that occur during hospitalization.

scholarly journals MATERNAL NEAR MISS ANALYSIS AT TERTIARY CARE REFERRAL HOSPITAL

2021 ◽  
pp. 1-3
Author(s):  
Chavan L G ◽  
Bangal V B ◽  
Mange K R
Keyword(s):  
Severe Hypertension ◽  
Kidney Diseases ◽  
Post Partum ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Near Miss ◽  
World Health ◽  
Maternal Near Miss ◽  
Cross Sectional ◽  
Systematic Analysis

Introduction-The World Health Organization defines a maternal near-miss case as "a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy. Material and Methods- Prospective cross-sectional observational study was carried out over a period of two years. Systematic analysis of all maternal near miss cases was done in relation to causes, contributory factors, and associated socio demographic factors. Results-There were 22,318 deliveries including 87 maternal near miss cases during study period. Severe anemia (28.74%), severe hypertension (22.99%), ante-partum hemorrhage, post partum hemorrhage (18.39%), post-operative sepsis (9.2%), renal failure and hepatic dysfunction were major causes associated with maternal near miss situation. Conclusion- Severe anaemia, obstetric haemorrhage, severe hypertension and its complications, respiratory infection, sepsis, Liver and kidney diseases are mainly responsible for maternal near miss situation.

scholarly journals A prospective study on maternal near miss cases at a tertiary care hospital

2019 ◽  
Vol 9 (1) ◽  
pp. 300
Author(s):  
Karuna Kanta Das ◽  
Sasindra Kumar Das ◽  
Dhritimala Das
Keyword(s):  
Maternal Mortality ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Obstetric Care ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Care Hospital ◽  
Respiratory Dysfunction ◽  
Live Births ◽  
Tertiary Center

Background: Pregnant women’s health status is not only reflected by mortality indicators alone hence the concept of Severe Acute Maternal Morbidity (SAMM) is appropriate for present health providing system. It helps to evaluate the quality of obstetric care in a particular institute. The main objectives of the study were to find a) Incidence of MNMM; b) Disorders underlying MNMM; c) Socio-demographic variables among MNMM; d) Facilities and skills needed to handle these near miss situations.Methods: A prospective hospital-based study was conducted in the department of obstetrics and gynaecology, Gauhati Medical College and Hospital, Guwahati during the period 1st June 2018 to 31st May 2019. Cases were identified based on maternal near miss operational guidelines December 2014.Results: Out of 16222 live births, 241 near miss cases were identified during the study. The maternal near miss incidence ratio is 14.86 per 1000 live births. The maternal near miss to maternal mortality ratio is 2.025. Most common cause of MNMM is hemorrhage (48.54%) followed by hypertension (19.5%), anemia (13.28%), sepsis (10.37%), cardiac dysfunction (6.2%), liver dysfunction (0.83%), renal dysfunction (0.83%) and respiratory dysfunction (0.41%).Conclusions: The large magnitude of MNM cases may be attributed to improper management of obstetric emergencies at the referring hospitals, poor referral practices, inefficient transport system, limited availability of blood products and poor utilization of health care services at the peripheral hospitals. In our tertiary center, with the help of multidisciplinary action to all the near miss cases we can reduce maternal mortality to a great extent.

scholarly journals MATERNAL NEAR MISS IN A TERTIARY CARE HOSPITAL: A CROSS SECTIONAL STUDY

2016 ◽  
Vol 5 (51) ◽  
pp. 3252-3254 ◽  
Author(s):  
Namrata Ray ◽  
Sanjay Kumar Patil ◽  
Nitin Kshirsagar S ◽  
Yaminni Patil ◽  
Manisha Laddad
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Feto-maternal outcomes in near miss events in obstetrics

2021 ◽  
Vol 11 (1) ◽  
pp. 172
Author(s):  
Apoorva Kamboj ◽  
Kavita Mandrelle
Keyword(s):  
Maternal Morbidity ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Near Miss ◽  
North India ◽  
World Health ◽  
Maternal Near Miss ◽  
Retrospective Diagnosis ◽  
Near Miss Maternal Morbidity

Background: Maternal near miss is defined by world health organization as a woman, who being close to death survives a complication occurring during pregnancy, delivery or upto 42 days after her end of pregnancy.It is a retrospective diagnosis. Evaluation of near miss maternal morbidity and mortality is a surveillance method to assess the quality of obstetric care and determinants of poor maternal outcome. It is an indicator of quality of obstetrical care. Aims and objectives for current study was to evaluate the cause of near miss maternal morbidity in our hospital which occurred either in admitted patients or were referred from elsewhere and to study the maternal and fetal outcomes in all near miss cases.Methods: A retrospective review of obstetrical records as well as prospective analysis was done at Christian medical college and hospital, a tertiary care teaching institute in North India and referral centre. The study was done for a period of one year from November 2018 to October 2019 retrospectively and for 6 months from November 2019 to April 2020 prospectively. The maternal near miss cases were taken as per WHO criteria.Results: The age ranged from 19 years to 49 years with maximum belonging to age group of 20-24 years. Maximum number of cases was primigravida and was in third trimester. The primary obstetric complication evaluated were hypertensive disorders followed by hematological diseases, viral hepatitis, haemorrhage, and obstructed labour or ruptured uterus.Conclusions: All the causes of MNM observed in this study are preventable causes, which can be identified timely and treated early to prevent maternal mortality, thereby, improving obstetrical and neonatal outcome.

scholarly journals A study of maternal near miss cases at tertiary medical college of Jharkhand, India

2017 ◽  
Vol 6 (6) ◽  
pp. 2375 ◽  
Author(s):  
Samarina Kamal ◽  
Priyankur Roy ◽  
Shashibala Singh ◽  
Jacinta Minz
Keyword(s):  
Scoring System ◽  
Tertiary Care ◽  
Institutional Care ◽  
Good Alternative ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Hypertensive Disorder ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Life Threatening

Background: Maternal near miss is said to have occurred when women presented with life threatening complication during pregnancy, child birth and within 42 days after delivery, but survive by chance or good institutional care. For identifying near-miss cases five-factor scoring system was used. In 2009 WHO working group has standardized the criteria for selecting these cases.Methods: The study was conducted in the Department of Obstetrics and Gynecology at RIMS, Ranchi, Jharkhand, India, which is a tertiary care centre. For each case of near miss, data were collected on demographic characteristics including gestational age at the time of sustaining the near-miss morbidity, nature of obstetric complications, presence of organ-system dysfunction/failure, ICU admission and timing of near-miss event with respect to admission.Results: During the twenty-four months of the study period, 20000 deliveries at the institution and 480 women were identified as near-miss obstetrical cases by five factor scoring system. The prevalence of near-miss case in this study was 2.4%. Near-miss per 1000 delivery was 24%. Maternal death to near miss ratio was 1:7.2. The leading causes of maternal near miss were hemorrhage (42.5%) and hypertensive disorder of pregnancy (23.5%) The morbidity was high in unbooked cases.Conclusions: Maternal near miss is good alternative indicator of health care system.

scholarly journals A cross sectional study on severe acute maternal morbidity near-miss at tertiary care centre in Hyderabad, Telangana, India

2019 ◽  
Vol 8 (5) ◽  
pp. 1761
Author(s):  
Mahesh Kumar Mummadi ◽  
Sowmya Javvaji
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Near Miss ◽  
World Health ◽  
Maternal Near Miss ◽  
Severe Acute Maternal Morbidity ◽  
Life Threatening

Background: A maternal near-miss case is defined by World Health Organization (WHO) as “a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy.” Severe acute maternal morbidity (SAMM) is the acronym for the more popular term of ‘near-miss’ cases. There are approximately 118 life threatening events of “near miss mortality” or SAMM for each maternal death. Analysing near miss cases can prevent maternal death.Methods: It is a retrospective study based on medical records. Sample size is all the pregnant cases admitted in Department of Obstetrics and Gynecology in AIMSR, Hyderabad, Telangana, India over the period of January 2015- June 2017 (two and half years) i.e. 2276. All records were gathered and each record that satisfy near miss criteria/maternal mortality were segregated, data has been collected on the occurrence of severe pregnancy-related complications or those who require critical interventions and admission to intensive care unit as per the proforma (according to WHO near miss questionnaire). Data entry done in MS Excel and analyzed using Epi Info.Results: Total MNM/SAMM patients were 85 out of 2276 pregnant women (3.7%). The duration of the stay, potential life-threatening conditions (PTLC), critical interventions, organ dysfunctions, mode of delivery, treatment for PPH, hypertensive disorders and associated conditions among SAMM patients were calculated. SAMM patients who has severe post-partum hemorrhage PPH were 24.7%, severe pre-eclampsia was 31.7%, eclampsia was 2.4%, patients with both severe PPH and eclampsia were 2.4%.Conclusions: Near misses can be prevented to some extent by spreading awareness about possible obstetric complications and risk stratification. The WHO tool for analysis of maternal near miss or SAMM can identify more preventable causes of maternal death. Prospective monitoring of maternal morbidity may be useful in identifying determinants of severe maternal mortality.

scholarly journals Comparison between near miss criteria in a maternal intensive care unit

2018 ◽  
Vol 52 (0) ◽  
Author(s):  
Alana Santos Monte ◽  
Liana Mara Rocha Teles ◽  
Mônica Oliveira Batista Oriá ◽  
Francisco Herlânio Costa Carvalho ◽  
Helen Brown ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Maternal Death ◽  
High Sensitivity ◽  
High Specificity ◽  
Near Miss ◽  
World Health ◽  
Maternal Near Miss ◽  
Chi Square ◽  
Cross Sectional

ABSTRACT Objective: The aim of this study was to compare the incidence of different criteria of maternal near miss in women admitted to an obstetric intensive care unit and their sensitivity and specificity in identifying cases that have evolved to morbidity. Method: A cross-sectional analytical epidemiological study was conducted with women admitted to the intensive care unit of the Maternity School Assis Chateaubriand in Ceará, Brazil. The Chi-square test and odds ratio were used. Results: 560 records were analyzed. The incidence of maternal near miss ranged from 20.7 in the Waterstone criteria to 12.4 in the Geller criteria. The maternal near-miss mortality ratio varied from 4.6:1 to 7.1:1, showing better index in the Waterstone criteria, which encompasses a greater spectrum of severity. The Geller and Mantel criteria, however, presented high sensitivity and low specificity. Except for the Waterstone criteria, there was an association between the three other criteria and maternal death. Conclusion: The high specificity of Geller and Mantel criteria in identifying maternal near miss considering the World Health Organization criteria as a gold standard and a lack of association between the criteria of Waterstone with maternal death.

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