AI Article Synopsis
- The study aimed to analyze the incidence of near-miss maternal cases, maternal deaths, and related health quality indicators in a medical facility in Yavatmal, India, focusing on WHO-defined criteria.
- Among 29,754 emergency obstetric admissions, researchers identified 161 near-miss cases and 66 maternal deaths; the near-miss incidence ratio was 7.56 per 1,000 live births, while maternal mortality was at 2.99 per 1,000 live births.
- The major causes of near-miss cases included hemorrhage and anemia, while the leading causes of maternal mortality were PIH and sepsis; these preventable issues highlight ongoing challenges in maternal healthcare
Article Abstract
Objective: (1) To determine the incidence of near-miss, maternal death and mortality index; (2) to compare near-miss cases as per WHO criteria with that of maternal mortality; and (3) to study the causes of near-miss and maternal deaths.
Study Design: Retrospective cohort study.
Setting: Shri Vasantrao Naik Govt. Medical College, Yavatmal, India.
Study Population: All cases of near-miss as per newer WHO criteria and maternal deaths.
Methodology: A cohort of emergency obstetric admission in the study setting during the study period was followed till 42 days after delivery, and cases fulfilled WHO set of severity markers for near-miss cases for severe acute maternal morbidity (SAMM) and mortality. All maternal deaths during the same period were analysed and compared with near-miss ones.
Results: During the study period, there were 29,754 emergency obstetric admissions, 21,992 (73.91 %) total deliveries with 18,630 (84.71 %) vaginal deliveries and 3360 (15.28 %) caesarean deliveries. There were 161 near-miss cases and 66 maternal deaths occurred. The maternal near-miss incidence ratio was 7.56/1000 live births, while maternal mortality ratio was 2.99/1000 live births. Mortality index was 29.07, lower index indicative of better quality of health care. Maternal near-miss-to-mortality ratio was 3.43:1. Amongst near-miss cases, haemorrhage n = 43 (26.70 %), anaemia n = 40 (24.84 %), hepatitis n = 27 (16.77 %) and PIH n = 19 (11.80 %) were leading causes, while causes for maternal mortality were PIH n = 18 (27.27 %), haemorrhage n = 13 (19.79 %), sepsis n = 12 (18.18 %), anaemia n = 11 (16.16 %) and hepatitis n = 11 (16.66 %).
Conclusion: Despite improvements in health care, haemorrhage, PIH, sepsis and anaemia remain the leading obstetric causes of near-miss and maternal mortality. All of them are preventable. The identification of maternal near-miss cases using new WHO set of severity markers of SAMM was concurrently associated with maternal death. Definite protocols and standards of management of SAMM should be established, especially in rural Indian settings.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016477 | PMC |
| http://dx.doi.org/10.1007/s13224-016-0902-2 | DOI Listing |
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