scholarly journals Critical obstetric conditions during pandemic (COVID-19) and pre-pandemic years

2021 ◽  
Vol 6 (3) ◽  
pp. 56-63
Author(s):  
T. E. Belokrinitskaya ◽  
S. A. Iozefson ◽  
N. I. Frolova ◽  
O. Yu. Brum
Keyword(s):  
Maternal Mortality ◽  
Obstetric Care ◽  
Near Miss ◽  
Policy Makers ◽  
Mortality Index ◽  
Obstetric Haemorrhage ◽  
Severe Maternal Outcome ◽  
Quality Of Obstetric Care ◽  
Mortality Ratio ◽  
Life Threatening

Aim. To assess the structure of critical obstetric conditions and maternal mortality in Transbaikal Region in pandemic (COVID-19) and pre-pandemic years (2020 and 2019, respectively).Materials and Methods. We retrospectively analysed “near miss” (NM) and maternal deaths (MD) in 2019 and 2020, further calculating the severe maternal outcome ratio (SMOR), the summary indicator which includes both NM and MD per 1000 live births.Results. In a pandemic year (2020), we observed an increase in SMOR in comparison with a pre-pandemic year (3.0 vs 2.0, respectively). In 2019, maternal mortality was exclusively caused by obstetric complications, while extragenital pathology (cardiovascular disease and COVID-19) was responsible for that in 2020. However, the main causes of «near miss» in 2019 and 2020 were similar, including obstetric haemorrhage because of placental abruption and severe pre-eclampsia. Maternal near-miss mortality ratio (MNM/MD) increased from 7.3: 1 in 2019 to 11.3: 1 in 2020, and mortality index (MD/(MNM + MD) × 100) reduced from 12.0 to 8.1. Therefore, fewer women with life-threatening conditions died in 2020 as compared with 2019, indicating a better quality of obstetric care.Conclusion. Analysis of the critical obstetric conditions can probably find regional issues of maternal healthcare during the COVID-19 pandemic and propel the policy makers to find additional resources to minimise maternal morbidity and mortality.

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 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 MATERNAL NEAR MISS AND MATERNAL DEATHS IN KERALA, INDIA - A REVIEW

2020 ◽  
pp. 1-2
Author(s):  
Deepthy Balakrishnan
Keyword(s):  
Neurological Disorder ◽  
Maternal Morbidity ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Maternal Deaths ◽  
Live Births ◽  
Tertiary Centre ◽  
Mortality Index ◽  
Severe Maternal Outcome ◽  
Mortality Ratio

Aim- To determine the prevalence and pattern of near miss cases/ severe acute maternal morbidity cases and maternal deaths in a tertiary centre. Materials and methods - WHO 2011 criteria was used for identication of near miss cases. Results- In the study period of 2 years, there were 131 cases of severe maternal outcome (105 near miss and 26 maternal deaths). Maternal near miss incidence ratio is 5.62/ 1000 live births. Maternal near miss to mortality ratio is 4.03:1. The mortality index is 19.8%. Hemorrhage was the leading cause of near miss cases (44.76%) followed by hypertension(27.6%) but indirect causes(42.3%) led to maximum number of maternal deaths followed by hemorrhage. Among the indirect causes, cardiac and neurological disorder caused maximum mortality. Conclusion - Hemorrhage and hypertension were the leading causes of near miss but maternal mortality was more due to indirect causes. So it's important to involve specialist doctors from other departments to improve care of mothers and hence reduce maternal deaths further.

Near-Miss/Severe acute maternal morbidity (SAMM): A new concept in maternal care

1970 ◽  
Vol 24 (1) ◽  
pp. 29-33 ◽  
Author(s):  
S Jahan ◽  
K Begum ◽  
N Shaheen ◽  
M Khandokar
Keyword(s):  
Maternal Care ◽  
Case Fatality ◽  
Potential Method ◽  
Population Based ◽  
Near Miss ◽  
Hypertensive Disorders Of Pregnancy ◽  
Mortality Index ◽  
Obstetric Haemorrhage ◽  
Mortality Ratio ◽  
Obstetric Morbidity

A near-miss obstetric morbidity means a woman (in pregnancy/labour/puerperium) who almost died but survived. The near-miss: mortality ratio is a possible new indicator of maternal care and could be used to compare improvements in treatments more accurately than mortality date alone. Criteria to define and identify the cases vary greatly. The incidence ranges from 0.07% to 8.23% and the case fatality ratio from 0.02% to 37%. Massive obstetric haemorrhage and hypertensive disorders of pregnancy are two important primary obstetric causes of near-miss morbidity. Mortality index (MI) in one of the potential method of assessing the care received by SAMM cases. Population based surveys are considered preferable to collect informations of near-miss. (J Bangladesh Coll Phys Surg 2006; 24: 29-33)

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 Analysis of Near Miss Cases as a Reflection of Emergency Obstetric Services and Need of Obstetric ICCU

2013 ◽  
Vol 5 (3) ◽  
pp. 99-101
Author(s):  
Ajesh Desai ◽  
Vijay Kansara ◽  
Disha Vijay Sahijwani
Keyword(s):  
Maternal Mortality ◽  
Organ Dysfunction ◽  
High Mortality ◽  
Maternal Outcome ◽  
Near Miss ◽  
World Health ◽  
Live Births ◽  
Mortality Index ◽  
Severe Maternal Outcome ◽  
Obstetric Services

ABSTRACT Objectives World Health Organization (WHO) has defined near miss case as ‘a woman presenting any life-threatening condition and surviving a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy’. This study aims to calculate near miss rate (NMR), maternal mortality rate (MMR), severe maternal outcome ratio, and near miss maternal death of our hospital. Indications of near miss events (NME) and their mortality index and the incidence of each organ dysfunction and its mortality index have been studied. Design A retrospective study of hospital records was done to complete proforma and summarize obstetric and perinatal events from April 2011 to October 2011 at Civil Hospital, Ahmedabad. Near miss events were identified according to criteria of organ dysfunction given by Mantel et al 1998. Results Out of total 3, 242 live births, 97 NME occurred among which 27 expired. Thus, NMR and MMR of our hospital is 21.5 per 1,000 and 832.8 per 100,000 live births respectively. Severe maternal outcome ratio is 29.9 (97/3242) and maternal mortality to near miss ratio is 1:2.58. Mortality index of our institute is 27.8% (27/97). 80.4% patients developed NME before hospitalization. Severe-PIH was the most common cause of NME but carried a low mortality index of 5.8%. Whereas, complicated cases of malaria and hepatitis E had high mortality index of 75 and 38.8% respectively. Conclusion This study describes a relatively high mortality index and NMR (21.5/1,000 live births) as compared to data from other developing countries. How to cite this article Sahijwani DV, Desai A, Kansara V. Analysis of Near Miss Cases as a Reflection of Emergency Obstetric Services and Need of Obstetric ICCU. J South Asian Feder Obst Gynae 2013;5(3):99-101.

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 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

2009 ◽  
Vol 16 (01) ◽  
pp. 135-138
Author(s):  
TASNIM TAHIRA REHMAN ◽  
MAHNAZ ROOHI
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Mortality Ratio ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Care Level ◽  
Maternal Deaths ◽  
Mortality Ratio ◽  
Study Setting ◽  
Very High

Objective: To find out maternal mortality ratio (MMR) and to determine major causes of maternal death. S t u d y d e s i g n:A descriptive study. Setting: Department of Obstetric and Gynaecology, Allied Hospital, Faisalabad. S t u d y period: From 01.01.2008 to31.12.2008. Materials a n d m e t h o d s : All cases of maternal death during this study periods were included except accidental deaths. Results:There were 58 maternal deaths during this period. Total No. of live births were 5975. MMR was 58/5975 x 100,000 = 970/100,000 live births.The most common cause of maternal death was hemorrhage (34.5%) followed by hypertensive disorders/eclampsia (31%). Most of thepatients (75.86%) were referred from primary & secondary care level. C o n c l u s i o n : Maternal mortality is still very high in underdevelopedcountries including Pakistan. We must enhance emergency obstetric care (EOC) to achieve the goal of reduction in MMR.

Critical cases of maternal mortality - a severe obstetrical complication, reflecting the quality of medical services provided

2017 ◽  
pp. 27-30
Author(s):  
Yu.V. Dondyuk ◽  
Keyword(s):  
Maternal Death ◽  
Maternal Morbidity ◽  
Obstetric Care ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Maternal Deaths ◽  
Republic Of Moldova ◽  
Mortality Index ◽  
The Republic

Maternal near miss and maternal death audit has become an esssential process in the context of obstetric care in both developed and developing countries. The objective: of the present study was to assess the quality of medical services provided within the multilevel regionalized Perinatal Health System in the Republic of Moldova, by identifying the inconsistencies with existing standards of medical care, in cases of severe obstetric complications and maternal deaths. Materials and methods. All cases of maternal near miss cases and maternal deaths recorded in the Secondary and Tertiary Perinatal Centers of the Republic of Moldova during the period 2009–2014 were analyzed retrospectively. To assess the quality of obstetric care, the following indices have been calculated: maternal near miss/ maternal deaths ratio; the mortality index for each obstetric condition/ complication. Results. During a period of 6 years, in 11 Secondary and Tertiary Perinatal Centers of the Republic of Moldova there were registered 154 651 births, 2881 cases of maternal near miss and 21 maternal deaths. The General Mortality index was 0.72%, and the Mortality Index by direct obstetric morbidity was 0.48%. 92.86% of maternal deaths through direct obstetric causes were avoidable, and the proportion of near miss cases with substandard care was 81.85%. The most frequent gaps (82.48%) were caused by human factors, such as insufficient team work, communication deficiency, lack of knowledge and clinical skills necessary to properly recognize and treat critical obstetric patients, delay and errors in diagnosis and treatment, non-compliance with clinical protocols. Conclusions. The excessively high proportion of avoidable factors highlighted in the study is alarming and implies the need for more extensive activities and the development of strategies focused on ensuring the presence of qualified medical workers in medical institutions, which will allow the provision of qualitative care and safety for patients in the Republic of Moldova, reducing maternal morbidity and mortality. Key words: severe maternal morbidity, maternal near miss, maternal death, maternal mortality.

Sign in / Sign up

Export Citation Format

Share Document