scholarly journals Cost of maternal near miss and potentially life-threatening conditions, Kenya

2021 ◽  
Vol 99 (12) ◽  
pp. 855-864
Author(s):  
Kenneth Juma ◽  
Joshua Amo-Adjei ◽  
Taylor Riley ◽  
Winstoun Muga ◽  
Michael Mutua ◽  
...  
Keyword(s):  
Near Miss ◽  
Maternal Near Miss ◽  
Life Threatening

scholarly journals Maternal Near Miss in Patients with Systemic Lupus Erythematosus

2021 ◽  
Author(s):  
Arlley Cleverson Belo Silva ◽  
Sue Yazaki Sun ◽  
Felipe Favorette Campanharo ◽  
Letícia Tiemi Morooka ◽  
José Guilherme Cecatti ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Maternal Death ◽  
Lupus Erythematosus ◽  
Neonatal Death ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Control Group ◽  
Systemic Lupus ◽  
Increased Risk ◽  
Life Threatening

Abstract Introduction: Systemic lupus erythematosus (SLE) may cause irreversible organ damage. Pregnancy with coexisting SLE may have severe life-threatening risks. Severe maternal morbidities (SMM) include maternal death, maternal near miss (MNM), and potentially life-threatening conditions (PLTC). This study aimed to determine the prevalence of SMM in patients with SLE and analyze the parameters that contributed to cases of greater severity. Methods: This is a cross-sectional retrospective study from analysis of data retrieved from medical records of pregnant women with SLE treated at São Paulo Hospital , Brazil, from 2005 to 2015. The pregnant women were divided in control group without complications, group with PLTC, and group with MNM. Results: Out of 149 pregnancies, there were 14 cases of MNM (9.4%), 56 cases of PLTC (37.6%), and no maternal death. The maternal near miss rate was 112.9 per 1,000 live births. The majority of PLTC (83.9%) and MNM (92.9%) cases had preterm deliveries with statistically significant increased risk compared with control group [p=0.0042; OR (95% CI): 12.05 (1.5-96.6) for MNM group and p=0.0001; OR (95% CI): 4.84 (2.2-10.8) for PLTC group]. SMM increases the risk of longer hospitalization [p<0,0001; OR (95% CI): 18.8 (7.0-50.6) and p <0.0001; OR (95% CI): 158.17 (17.6-1424,2) for PLTC and MNM, respectively], newborns with low birth weight [p=0.0006; OR (95% CI): 3.67 (1.7-7.9) and p=0.0009; OR (95% CI): 17.68 (2-153.6) for PLTC and MNM group, respectively] as well as renal diseases [PLTC (58.9%, 33/56; p = 0.0069) and MNM (78.6%, 11/14; p = 0.0026)]. MNM cases presented increased risk for neonatal death [p=0.0128; OR (95% CI): 38.4 (3.3-440.3)], stillbirth and miscarriage [p=0.0011; OR (95% CI): 7.68 (2.2-26.3)]. Conclusion: SLE was significantly associated with severe maternal morbidity, longer hospitalizations, and increased risk of poor obstetric and neonatal outcomes, such as prematurity, neonatal death, miscarriage and fetal loss.

scholarly journals Proportion of Maternal Near-Miss and Its Determinants among Northwest Ethiopian Women: A Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Mengstu Melkamu Asaye
Keyword(s):  
Cross Sectional Study ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Sectional Study ◽  
Monthly Income ◽  
Cross Sectional ◽  
Factors Associated ◽  
Induced Hypertension ◽  
Life Threatening ◽  
The University

Background. Life-threatening situations might arise unexpectedly during pregnancy. Maternal near-miss can be a proxy for maternal death and explained as women who nearly died due to obstetric-related complications. It is recognized as the predictor of level of care and maternal death. Maternal near-miss evaluates life-threatening pregnancy-related complications, and it directs the assessment of the quality of obstetric care. Objective. To determine the proportion and factors associated with maternal near-miss at maternity wards at the University of Gondar Referral Hospital, Northwest Ethiopia, 2019. Methods. A cross-sectional study design was carried out from March 1 to June 20, 2019, using WHO criteria for maternal near-miss at the University of Gondar Referral Hospital. The data are from the interviews and review of 303 systematically selected participants’ medical files at maternity wards. Bivariate and multivariable logistic regression analyses were performed to analyze factors associated with maternal near-miss, including estimation of crude and adjusted odds ratios and their respective 95% confidence intervals and p value less than 0.05 through SPSS version 20. Result. The study revealed that the proportion of maternal near-miss was found to be 15.8% (95%CI=11.9%-20.1%). In the adjusted analyses, maternal near-miss was significantly associated with low (≤1000 ETB) monthly income (AOR=399; 95%CI=1.65, 9.65), seven or more days of hospital stay (AOR=5.43; 95%CI=2.49, 11.83), vaginal bleeding (AOR=2.75, 95%CI=1.17, 6.47), and pregnancy-induced hypertension (AOR=5.13; 95%CI=2.08, 12.6). Conclusion and Recommendation. The near-miss proportion was comparable to that in the region. Associated factors were low monthly income, seven or more days of hospital stay, vaginal bleeding, and pregnancy-induced hypertension. Thus, giving attention on early identification and treatment of these potential factors can be the opportunity in the reduction of 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 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.

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 Profile of maternal near miss and determinant factors in a Teaching Hospital, Southwestern Nigeria

2018 ◽  
Vol 7 (9) ◽  
pp. 3450 ◽  
Author(s):  
Olusola P. Aduloju ◽  
Tolulope Aduloju ◽  
Oluwadare M. Ipinnimo
Keyword(s):  
Maternal Death ◽  
Uterine Rupture ◽  
Cross Sectional Study ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Southwestern Nigeria ◽  
Cross Sectional ◽  
High Dependency ◽  
Mortality Index ◽  
Life Threatening

Background: Maternal near miss (MNM) concept is becoming a tool for the assessment of severe maternal morbidity. The study examined the profile of MNM cases and their determinant factors.Methods: A cross-sectional study of pregnant women with near miss cases and maternal death using the WHO criteria between 1st January 2015 and 31st December 2016. Relevant data were collected with using a structured data form, analyzed using SPSS version 22 and logistic regression was done to determine factors associated with MNM.Results: The MNM incidence ratio was 17.4/1000 live births with overall mortality index of 17.5%. Hemorrhage (39.4%) was the commonest cause of MNM while uterine rupture (42.8%) was the most common cause of maternal death. Also, uterine rupture had the highest mortality index of 33.3%. Older age group, low education, rural dwellers and unbooked status of women were the significant determinants of MNM, p <0.05. The overall maternal death to near miss ratio was 1:4.7. The worst perinatal outcome occurred in women who suffered maternal death.Conclusions: The study showed suboptimal level of care for women with life threatening conditions. There is a need to develop evidence-based protocol for their management and provision of high dependency unit.

scholarly journals Maternal Near-Miss Obstetric Events and Maternal Mortality

2021 ◽  
Vol 15 (5) ◽  
pp. 980-983
Author(s):  
Shehla Channa ◽  
Hina Akmal Memon ◽  
Nayab Qasim ◽  
Abdul Rauf Memon ◽  
Ikram Ahmed Tunio ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Live Birth ◽  
Maternal Death ◽  
Maternal Health Services ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Cross Sectional ◽  
Life Threatening

Aim: To know about the prevalence, characteristic and nature of near miss events and to relate the nature of near miss events with that of maternal mortality. Study design: Descriptive cross sectional study Place and duration of study: Department of Obstetrics & Gynecology Unit IV, LUMHS Jamshoro from 1st January 2020 to 31st December 2020 Methodology: Pregnancy outcomes segregated into maternal death, near-miss event, or live birth categories. Age, level of education, religion, and residence were socio demographic variables. Obstetrics characteristics and nature of maternal near-miss events also studied. Result: The prevalence of maternal near-miss event was 5.6%, and the maternal near-miss events were seen more in multigravida, pregnant women with the lack of antenatal care in referral cases. Live birth as fetal outcome was 75%. The maternal death to near-miss ratio in this study was 1:5. 44 (42.3%) postpartum haemorrhage and 28 (26.9%), hypertensive disorders cases were leading cause of maternal near-miss events. Conclusion: Every fifth women who survived life-threatening complications, one died. Maternal near-miss should be adopted as an indicator for evaluating maternal health services. Keywords: Maternal near-miss (MNM), Maternal mortality, Life-threatening complication

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.

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