Publication:

Study of maternal near miss cases at a tertiary centre

Background When evaluating the quality of a women's health care system, maternal mortality serves as a sentinel occurrence. Since death rates are steadily declining, attention is now being paid to maternal near misses, which characterize severe maternal morbidity and have a shared pathway with mortality.

Methods This is a retrospective descriptive study carried out in department of obstetrics and gynaecology of Khaja Banda Nawaz University- Faculty of medical sciences, over six months. All women who fulfil the World Health Organisation (WHO) criteria of Maternal Near Miss (MNM) were included in the study. Relevant demographic and obstetric, further course and events leading to maternal near miss were studied. Finally, the indices like maternal near miss incidence ratio, maternal near miss: maternal mortality ratio and mortality index were calculated.

Results Total 124 women were recognized as near-miss instances out of 812 deliveries that occurred at our institution throughout the 6 months research period. The prevalence of near-miss case was 2.56%. The maternal near-miss to death ratio was 124:2, and the maternal near-miss ratio was 155 per 1000 live births. The most frequent cause of maternal near misses was obstetric haemorrhage, which occurred in 44.1% of cases, while the most prevalent medical co-morbidity was hypertensive condition of pregnancy (60.1%). Referral cases made up the majority of the cases (79.2%).

Conclusions Analysing maternal near-miss incidents provides valuable insight into our healthcare system. Peripheral emergency obstetric care training contributes to a decrease in maternal morbidity overall and lessens the strain on healthcare system.