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Maternal Near Miss: A Valuable Contribution in Maternal Care

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Abstract

Background

MMR has always been recognized as an important indicator of quality of health services. The MMR in India has so far not reached up to the required MDG 2015. If we look into this matter with the eagle’s eye view, then there are certain gray areas which need attention. For this, it is not the maternal mortality but the maternal near miss which has to be focused.

Objectives

To audit the maternal near miss in our institution and to review the pathways that lead to severe maternal morbidity and death.

Methods

Prospective observational study from September 2013 to August 2015 in Dr. Bhim Rao Ambedkar Memorial Hospital, Raipur. Maternal near miss cases were identified based on WHO criteria 2009, recorded, and studied.

Results

There were 13,895 live births, 211 maternal near miss, and 102 maternal deaths. Maternal near miss to mortality ratio was 2:1. Maternal near miss incidence ratio was 15.18/1000 live births. Mortality index was 32.58 %. Hemorrhage and hypertensive disorders of pregnancy toped the list of the leading causes of near miss morbidity. The near miss events were more common in the primipara (39 %), with age group 21–30 years and in the third trimester at the time of admission.

Conclusion

Auditing maternal near miss can help in reducing their morbidity and mortality in our institution. Similar audit between other institute, state, and countries may help to hasten the slow progress of reducing maternal mortality.

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References

  1. Tajik P, Nedjat S, Afshar NE, et al. Inequality in maternal mortality in Iran: an ecologic study. Int J Prevent Med. 2012;3(2):116–21.

  2. Trends in maternal mortality: 1990 to 2015 Estimate by WHO, UNICEF, UNFPA, World bank group and the united nations population division. WHO Ref. no. WHO/RHR/15.23. 2015

  3. Shreshta NS, Karki C, Saha R. Near miss maternal morbidity and maternal mortality at Kathmandu Medical College Teaching Hospital. Kathmandu Univ Med J. 2010;8(30):222–6.

    Google Scholar 

  4. Ranatunga GA, Akbar JF, Samarathunga S, et al. Severe acute maternal morbidity in a tertiary care institution. Sri Lanka J Obstet Gynecol. 2012;34:135–43.

    Google Scholar 

  5. Knight HE, Self A, Kennedy SH. Why are women dying when they reach hospital on time? A systematic review of the ‘third delay’. PLoS one. 2013;8(5):e63846. doi:10.1371/journal.pone.0063846.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Win T, Vapattanawong P, Vong-ek P. Three delay related to maternal mortality in Myanmar: a case study from maternal death review, 2013. J Health Res. 2015;29(3):179–87.

    Google Scholar 

  7. Pacagnella RC, Cecatti1 JG, Parpinelli MA, et al. Delays in receiving obstetric care and poor maternal outcomes: results from a national multicentre cross-sectional study. BMC Pregnancy Childbirth. 2014;14:159. http://www.biomedcentral.com/1471-2393/14/159.

  8. Coverage Evaluation Survey 2009-Chhattisgarh fact sheet.ghdx.healthdata.org/record/india-coverage-evaluation-survey-2009-1010.

  9. Sarma HKD, Sarma HK, Kalita AK. A prospective study of maternal near-miss and maternal mortality cases in FAAMCH, Barpeta; with special reference to its aetiology and management: first 4 months report. J Obstet Gynaecol Barpeta. 1(2).

  10. Murthy BK, Murthy MB, Prabhu PM. Maternal mortality in a tertiary care hospital: a 10-year review. Int J Prev Med. 2013;4:105–9.

    PubMed  PubMed Central  Google Scholar 

  11. Mhyre JM, Bateman BT, Leffert LR. Influence of patient comorbidities on the risk of near-miss maternal morbidity or mortality. The American Society of Anesthesiologists, Inc., Lippincott Williams & Wilkins. Anesthesiology. 2011;115:963–72.

    Article  PubMed  Google Scholar 

  12. Kallur SD, Vada BP, Reddy P, et al. Organ dysfunction and organ failure as predictors of outcomes of severe maternal morbidity in an Obstetric Intensive Care Unit. J Clin Diagn Res. 2014;8(4):OC06–8. doi:10.7860/JCDR/2014/8068.4213.

    PubMed  PubMed Central  Google Scholar 

  13. Nacharaju M, Sudhir P, Kaul R, et al. Maternal near miss: an experience in rural medical college. J Evol Med Dent Sci. 2014;3(56):12761–7. doi:10.14260/jemds/2014/3693.

    Google Scholar 

  14. Roopa PS, Verma S, Rai L, et al. “Near miss’’ obstetric events and maternal deaths in a Tertiary Care Hospital: an audit. Hindawi Publishing Corporation. J Pregnancy. 2013.

  15. Das I, Datta M, Samanta S, et al. A cross-sectional study on post-partum severe acute maternal morbidity and maternal deaths in a Tertiary Level Teaching Hospital of Eastern India. Int J Women’s Health Reprod Sci. 2014;2(3). ISSN 2330-4456.

  16. Kalra P, Kachhwaha CP. Obstetric near miss morbidity and maternal mortality in a Tertiary Care Centre in Western Rajasthan. Indian J Publ Health. 2014;58(3).

  17. Bakshi RK, Roy D, Aggarwal P, et al. Demographic determinants of maternal “near-miss” cases in rural Uttarakhand. Natl J Community Med. 2014;5(3).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Pt. JNM Medical College Raipur, E-8 Shankar Nagar, Raipur, 492001, India

    Singh Abha

  2. Department of Obstetrics and Gynecology, Pt. JNM Medical College Raipur, F 7 Block 2 Pt JNM Medical College Campus, Raipur, 492001, India

    Shrivastava Chandrashekhar

  3. Department of Obstetrics and Gynecology, Pt. JNM Medical College Raipur, Shri Ram Hospital, Dagania, Mahadeoghat Road, Raipur, 492001, India

    Dube Sonal

Authors
  1. Singh Abha
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  2. Shrivastava Chandrashekhar
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  3. Dube Sonal
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Corresponding author

Correspondence to Shrivastava Chandrashekhar.

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Conflict of interest

Dr. Abha Singh, Dr. Chandrashekhar Shrivastava, and Dr. Sonal Dube declared that they have no conflicts of interests.

Ethical Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

As this is an observational study informed consent was not required.

Additional information

Dr. Abha Singh is the Director professor and Head in Department of Obstetrics and Gynecology at Pt. JNM Medical college Raipur; Dr. Chandrashekhar Shrivastava is the Associate Professor in Department of Obstetrics and Gynecology at Pt. JNM Medical college Raipur; Dr. Sonal Dube is a third-year PG student of MD in Department of Obstetrics and Gynecology at Pt. JNM Medical College Raipur.

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Abha, S., Chandrashekhar, S. & Sonal, D. Maternal Near Miss: A Valuable Contribution in Maternal Care. J Obstet Gynecol India 66 (Suppl 1), 217–222 (2016). https://doi.org/10.1007/s13224-015-0838-y

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  • DOI: https://doi.org/10.1007/s13224-015-0838-y

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