“BEFORE IT’S TOO LATE….” A CLINICAL STUDY OF MATERNAL NEAR MISS CASES AT TERTIARY CARE CENTRE
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 6443-6450
AbstractBackground: In India there is a decline in MMR compared to 2010 statistics. Severe Acute Maternal Morbidity (SAMM) has been introduced to analyze the quality of the health care system, thus to improve the obstetric care. SAMM and Near Miss events are complimentary to MMR. This concept was defined by the World Health Organization (WHO) as “a woman who, being close to death, survives a complication that occurred during pregnancy, delivery or up to 42 days after the end of her pregnancy”.
Aim: To estimate the magnitude, associated Morbidity, various interventions and maternal and perinatal outcome for near miss cases (MNM) at tertiary care center.
Method: The prospective observational study was conducted in a Government medical college and hospital, Aurangabad from 2018 to 2020 after Institution Ethics Committee approval. Data of 350 near miss cases were analysed and also categorized based on adverse event identified in 1) Pregnancy Specific Obstetric and Medical disorder 2) Pre-Existing disorders aggravated during pregnancy 3) Accidental/Incidental disorders of pregnancy.
Results: The magnitude of near miss cases (MNM) was found to be 1.10 per 1000 live birth and maternal mortality (MMR) observed was 0.41 per 1000 live birth. Maternal near miss to maternal death ratio was 2.71:1. In present study anaemia (65.43%) and PIH (64.29%) was associated risk factors of maternal near miss. Further it was seen that the causes of MNM was Atonic PPH in 64% of cases followed by severe preeclampsia in 54% of cases.
Conclusion: It can be concluded from this study that hemorrhage during pregnancy are the most common cause maternal morbidity in the study group, followed by ruptured ectopic pregnancy. Hence, services at the grass route level helps in early identification, treatment and proper referral of complicated pregnancies should be made available. Proper insemination IEC activities of the primary health care staff about the complication among the antenatal mothers, their referral and further evaluation of the disorder should be given.
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