A Prospective Observational Study of Near-Miss Maternal Cases in A Tertiary Care Hospital
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 3
Abstract
Introduction: WHO estimates that 15% of all pregnant women will develop direct obstetric complications such as hemorrhage, obstructed or prolonged labor, pre-eclampsia or eclampsia, sepsis, ruptured uterus, ectopic pregnancy and complications of abortion. Exploring the similarities, the differences and the relationship between the women who died and those who survived life-threatening conditions provide a more complete assessment of quality in maternal health care. The present study was done to determine the near miss cases and to determine the main causes of this situation. Material and methods: A prospective cross-sectional study was carried out in the department of obstetrics and gynecology, in a tertiary referral center for a period of 8 months. The total number of near miss cases, maternal mortalities and total live births were used to calculate the following indices: Maternal mortality ratio, Severe morbidity ratio and Mortality index. All the data was arranged in a tabulated form and analyzed using SPSS software. Results: The study enrolled 100 subjects; the mean age was 27.63 years. Forty one percent(41.0%) of the cases were primigravida and 19.0% of the cases each were secondary and third gravida. There were 55.0% of the cases that had clinical criteria followed by 16.0% of the cases that had both Clinical and Management criteria by WHO identification. Organ dysfunction was seen in 5% cases. Severe post partum hemorrhage and anemia was seen in 14% and 13% cases respectively. Severe acute thrombocytopenia and ruptured uterus was seen in 4% cases. Liver dysfunction was also seen in 4% cases. Eclampsia was seen in 12% cases. Cardiac and neurological dysfunction was seen in 1% cases each. Conclusion: We conclude that studying near-miss cases can provide valuable information and their review is likely to yield information on the same pathways that lead to severe morbidity and death. The number of maternal near-miss cases is more than the maternal deaths and the cases are alive to directly inform on problems and obstacles that had to be overcome during the process of health-care
Authors and Affiliations
Saumya Niviti, Shreya Prabhoo, Chandrashekhar Hegde
Keywords
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