Background: Despite therapeutic advances during this century and growing perception of the safety of child birth, morbidity and mortality continue to occur in obstetric patients. Maternal mortality was considered the critical indicator to assess the quality of services provided by a health care system. Maternal mortality is just the tip of iceberg where maternal morbidity remains largely undescribed. Maternal near miss fill this gap. Maternal near miss is defined as women who survives life threatening condition during pregnancy abortion and child birth or within 42 days of pregnancy termination, irrespective of receiving emergency medical or surgical intervention. Maternal near miss are more common than maternal death and studying maternal near miss cases can become a useful tool to design the strategies to improve the maternal outcome. Thus, near miss is a leading indicator to maternal mortality that, if scrutinized and used correctly, can prevent both mortality and severe morbidity.
Objectives: To study the clinical and epidemiological profile of maternal near miss in a tertiary care centre.
Methods: A retrospective case sheet based descriptive study was conducted in the department of obstetrics and gynaecology, government medical college, Thiruvananthapuram. All maternal near miss cases admitted in the department during 2019 may 1st to 2020 April 30th were included in the study. The data was extracted from the near miss register kept in the department and inpatient register kept in medical records. The information on the sociodemographic characteristics of the women like age parity educational status place of residence occupation and obstetric and medical history such as mode of delivery complication during pregnancy other comorbidities were collected and entered into proforma. All these data were then entered into excel sheet and analysis was done using statistical software SPSS v26.0.
Results: It was found that haemorrhage was the leading cause of maternal near miss constituting about 57.14% of cases. Of which atonic PPH was the most common cause of PPH 35.71%. There is an alarming increase in number of adherent placenta which constitute about 32.1% of cases. 44.8% of PPH needed obstetric hysterectomy. Sepsis constituted the next largest group accounting for 17.24% of maternal near miss, followed by hypertensive disorders of pregnancy.
Conclusion: The most common cause of maternal near miss was haemorrhage in which atonic PPH accounts for the majority of near miss. Adherent placenta constituted 32.1% of haemorrhage. sepsis and hypertensive disorder of pregnancy were found to be the next major causes.
International Journal of Clinical Obstetrics and Gynaecology
Indexed in Index Copernicus
Research Journals