Maternal near miss: A single centric experience

Abstract

Introduction: Investigating severe maternal morbidity (near-miss) is a newly recognized tool which helps to identify women at highest risk of maternal death and helps allocate resources especially in low income countries. Aims and Objectives: 1. Document frequency and nature of maternal near miss. 2. Evaluate the level of care at maternal life saving emergency services. Methods: It was a retrospective study conducted at Santokba Durlabhji Memorial Hospital, Jaipur (India) during September 2017 to August 2018. The study population included near miss cases and maternal deaths. The WHO near miss criteria 2009 was followed including clinical, laboratory and management based criteria for case identification. Results: Out of 2805 deliveries, 98 were near miss cases and 5 maternal deaths during the study period. The maternal near miss incidence ratio was 35/1000 live births. Most cases were referred to at perinatal period. Amongst the near-miss cases sepsis (36.5%) was the most common cause followed by haemorrhage (22.5 %) and hypertension (22.2 %). 60% required direct ICU admission.Conclusion: Near miss/mortality is an important indicator of the health care system of any country. Stress should be more towards training and improving services at district level. There should be a good referral system and patients with antenatal complications should be referred with fetus in utero to have a better feto-maternal outcome. Availability of adequate amount of blood products at district level could change the outcome drastically.