Comparison of Causes of Maternal Near Miss and Maternal Mortality in a Tertiary Care Hospital: A Prospective Study

Abstract

The Maternal Near miss (MNM) concept has led to a more comprehensive and better assessment of the effect of care on maternal health. Investigating severe life-threatening pregnancy complications that women encounter and maternal morbidities (near misses) may help evaluate the quality of care in health facilities and recommend ways to improve maternal survival, especially in poor resource settings. Aim This study aimed to identify causes, classify, and determine the nature of complications in maternal near misses and in maternal death. Material and Methods The hospital-based prospective cohort study was conducted in the Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Aligarh Muslim University of Aligarh from 2020 to 2022. The study was approved by the Institutional Ethics Committee and informed written consent was obtained from the study participants. The outcome measures included causes, organ dysfunction, complications, maternal morbidities, and neonatal outcome. Results: Higher rate of unbooked referrals was observed in our study. Hemorrhage was 42.9%, followed by 39.1% hypertensive disorders, 8.6% sepsis in the maternal near miss group while in the maternal mortality group, 26.1% had hypertensive disorders followed by 23.8% women had hemorrhagic disorders, and 20.4% had sepsis. There was a significant difference in HDU, ICU Hospital stay and IUDs in the maternal mortality group compared to the maternal near-miss group. Conclusion The WHO near-miss approach was found to represent a feasible strategy in low-resource settings each Near Miss should be evaluated in detail to diagnose underlying pathology, correct and timely detection of complications, prompt referral and early institution of essential and comprehensive obstetrics care are important for maternal and infant survival.