Publication:

Study of maternal near miss as an indicator of quality of obstetrics care in tertiary care centre: a prospective study

Background Maternal near miss is said to have occurred when women presented with life threatening complication during pregnancy, childbirth 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 these cases.

Methods The study was a descriptive study done for the period of 18 months between 1st June 2021 to 31st December 2022 conducted in the department of Obstetrics and Gynecology at Bundelkhand Medical College Sagar, Madhya Pradesh, India, which is a tertiary care centre. For each cases of near miss, data were collected on demographic characteristics including gestational age at the time of sustaining the near morbidity, nature of obstetric complications, presence of organ dysfunction/failure, ICU admission and timing of near miss event with respect to admission.

Results A total numbers of 12252 live births were, 28 maternal deaths and 372 MNM cases were reported during the study period. Incidence of MNM was 30.3 %. In present study mortality index is 0.07. Maternal near miss to mortality ratio is 13.2:1. Hypertensive disorder of pregnancy 44.4% were most common cause of MNM followed by severe anemia 23% cases.

Conclusions Critical analysis of MNM cases will help us in identifying the deficiencies in obstetric care. Maternal mortality and morbidity can be reduced if timely and effective care can be given to women experiencing acute pregnancy related complications .There is need for validation of MNM criteria at peripheral level which will enable them in early identification and timely referral of such cases to tertiary centers.