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Incidence of Maternal “Near-Miss” Events in a Tertiary Care Hospital of Central Gujarat, India

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The Journal of Obstetrics and Gynecology of India Aims and scope Submit manuscript

Abstract

Background

Constant decline in maternal mortality ratio has given rise to the need of a new indicator. This search has motivated investigation of severe maternal morbidity—“maternal near-miss” (MNM) event. World Health Organization (WHO) defines MNM as “a woman who, being close to death, survives a complication that occurred during pregnancy, delivery or up to 42 days after the end of her pregnancy”.

Methodology

A hospital-based cross-sectional study was carried out at Sir Sayajirao General Hospital (SSGH), a tertiary care referral hospital in Vadodara, Central Gujarat, from May to September 2012. MNM events were identified according to either WHO or Mantel et al. criteria or both.

Results

During study period, 1929 live births, 18 maternal deaths and 46 “near-miss” cases were recorded. Among these 46 near-miss cases, 57 near-miss events were identified. Calculated MNM ratio was 23.85/1000 live births, MNM rate was 20.6/1000 obstetric admissions, the ratio of maternal death to MNM event was 1:2.6, and overall Mortality index was 28.1 %. Among near-miss cases, percentage of preterm delivery was 42 % and stillbirth rate was 35 % (16/46). Out of 46 MNM, pregnancies were continued in 3 while 43 pregnancies were terminated. (25 live births, 16 stillbirths, 2 abortions).

Conclusion

Identification of preventable factors and special preventive actions should be taken for management of complications in such near-miss cases.

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Acknowledgments

We are thankful to Dr. Chandresh Pandya, Associate Professor, Community Medicine Department and Dr. R K Baxi, Professor, Community Medicine Department, whose incessant efforts in guiding this study have been of pivotal importance. We are indebted to Dr Kalpita Shringarpure for their valuable support from inception to execution of this study and its final shape. We are thankful to the Head of Department, Obstetrics and Gynaecology, all resident doctors of Obstetrics and Gynaecology wards and Medical Superintendent of the hospital for their continuous support throughout the process of data collection and for allowing study and to use data for the study. We are highly obliged to all the study participants, who willingly and enthusiastically participated in the study; without their support, the study would not have been possible.

Funding

This study was not funded by any kind of funding agency.

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Authors and Affiliations

  1. Department of PSM, Medical College Baroda, Raopura, Vadodara, Gujarat, 390001, India

    Niyati T. Parmar, Ajay G. Parmar & Vihang S. Mazumdar

Authors
  1. Niyati T. Parmar
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  2. Ajay G. Parmar
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  3. Vihang S. Mazumdar
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Corresponding author

Correspondence to Niyati T. Parmar.

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Conflict of interest

Dr. Niyati Parmar declares that she has no conflict of interest. Dr. Ajay Parmar declares that he has no conflict of interest. Dr. Vihang Mazumdar declares that he has no conflict of interest.

Ethical Approval

Before starting enrolment of the participants, necessary clearances and permissions were obtained from concerned authorities including Scientific and Ethical Research Committee (SERC) for Human research. Scanned copy of which has been attached here with in additional document.

Informed Consent

At the time of data collection, the purpose of the study was clearly explained to the study subjects and they were also assured of the confidentiality of the information. The study subjects were enrolled in the study only after taking written informed consent.

Additional information

Dr. Niyati T. Parmar, Tutor in Department of PSM at Medical College Baroda; Dr. Ajay G. Parmar, Tutor in Department of PSM at Medical College Baroda; Dr. Vihang S. Mazumdar, Professor and Head of Department of PSM in Department of PSM at Medical College Baroda.

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Parmar, N.T., Parmar, A.G. & Mazumdar, V.S. Incidence of Maternal “Near-Miss” Events in a Tertiary Care Hospital of Central Gujarat, India. J Obstet Gynecol India 66 (Suppl 1), 315–320 (2016). https://doi.org/10.1007/s13224-016-0901-3

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  • DOI: https://doi.org/10.1007/s13224-016-0901-3

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