The aim of this study is to evaluate Maternal & Perinatal outcome in cases of Severe Acute Maternal Morbidity.
Result: All the 124 patients of severe acute maternal morbidity required either HDU/ICU admission for intensive/ invasive monitoring. Out of 124 patients, 65(52.4%) patients required operative interventions. 69 (55.64%) patients required the use ionotropes as immediate life saving measure as most of the patients came in hemorrhagic shock. Transfusion of blood and blood products was require in 99 (79.8%) patients.
Hemorrhage was the leading cause of severe acute maternal morbidity in our setting accounting for 62.9% of the cases, followed by hypertensive disorders of pregnancy representing 20.16% of total cases. In the present study 83.5% babies delivered at term and 16.49% were preterm. Preterm induction of labour had to be done in favour of maternal health. In the present study 41.75% of the babies were live and were discharged healthy. 53.8% babies were stillborn and 4.39% were neonatal deaths. Higher incidence of stillborn babies is attributed to the severe morbidity of the mother.
Conclusion: The most common reason of SAMM was Hemorrhage due to ruptured ectopic pregnancy, followed by Hypertensive disorders of pregnancy like eclampsia.
Active management of third stage of labor, easy availability of blood & blood products & timely surgical interventions has helped save lives of the patients suffering from Acute Blood loss & Hemorrhagic shock. SAMM review can be useful surrogate of maternal death analysis in this centre.
SAMM is mostly associated with adverse perinatal Outcome. All these factors could be minimized by initiating a broad debate on healthcare policies, mass education on good antenatal care, introducing preventive measures and improving the training of the health professionals and services providing obstetric care.