AI Article Synopsis

  • Maternal morbidity reflects the quality of maternal health services, and reviewing maternal near miss (MNM) cases can help reduce maternal mortality in India by highlighting important factors.
  • Various studies conducted in India between 2010 to 2019 identified a wide range of MNM incidence rates, with significant variations in criteria used for identification.
  • Hypertensive disorders and anaemia were found to be the main causes of MNM, and future research should adopt standardized criteria to provide consistent and useful data for improving maternal health outcomes.

Article Abstract

Background & Objectives: Maternal morbidity is an indicator of the quality of a country's maternal health services. Maternal near miss (MNM) can provide valuable information in this context and hence these cases need to be reviewed which can indirectly play a major role in reducing maternal mortality ratio in India. The objectives of the present review were to find the prevalence/incidence, criteria used for identification, review the causes of MNM cases and identify the contributory factors responsible for the occurrence of these cases based on three-delay model.

Methods: Articles were identified from the PubMed, Google Scholar, Scopus and Cochrane Library using search terms such as 'Maternal Near Miss','maternal morbidity', 'India' among others. All health facility-based observational studies conducted in India published between 2010 to 2019 irrespective of data collection period, and criteria used for identification of MNM cases were included for review. Data were extracted from included studies and summarized in terms of prevalence/incidence, ratio and percentage.

Results: Out of 25 studies, majority were prospective observational conducted at government health facilities. The incidence of MNM varied widely from 3.9 to 379.5 per 1000 live births and 7.6-60.4 per 1000 deliveries. MNM: Maternal Death varied from 1.7:1 to 21.8:1; studies used different criteria to define MNM cases.

Interpretation & Conclusions: Hypertensive disorders and anaemia were the leading direct and indirect causes of MNM, respectively. There was a lack of uniformity in using the criteria for MNM across studies conducted in India over the last decade. Future studies on MNM in India should follow the uniform criteria mentioned in the MNM-Review guidelines released by the Government of India in 2014 for obtaining systematic data and proper summary estimates.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9205009PMC
http://dx.doi.org/10.4103/ijmr.IJMR_928_19DOI Listing

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