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

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.