International Journal of Clinical Obstetrics and Gynaecology

Background: Maternal near-miss (MNM) events provide critical insights into the quality of obstetric care and factors contributing to severe maternal morbidity. Despite global efforts to reduce maternal mortality, significant challenges persist in identifying and managing life-threatening obstetric complications.

Objective: To analyze the primary causes, characteristics, and outcomes of maternal near-miss events in a tertiary care hospital setting.

Methods: A retrospective case series study was conducted over 12 months, analyzing 100 deliveries with 13 identified maternal near-miss cases. Data were collected using a standardized five-factor scoring system, examining clinical characteristics, organ dysfunctions, referral status, and system delays.

Results: The maternal near-miss ratio was 13 per 100 deliveries. Severe pre-eclampsia (30.8%) and postpartum hemorrhage (23.1%) were the predominant causes. The survival rate was 92.3%, with multilateral organ system involvement observed. Cardiovascular, coagulation, neurologic, and renal systems each showed 23.1% involvement. Notably, 69.2% of cases were referred, with 53.8% of complications identified before hospital arrival. Delay analysis revealed challenges in care-seeking (23.1%), facility access (23.1%), and care delivery (15.4%).

Conclusion: The study underscores the complexity of maternal near-miss events, highlighting the critical need for comprehensive approaches to maternal healthcare. Early detection, robust referral systems, and targeted interventions are essential in mitigating severe maternal morbidity.