‘Back From Beyond’ An Audit of Maternal Near Miss Cases

Abstract

Objective: The objective of the study is to audit the near miss cases, layer out the outcome in terms of severity, and figure out the interventions to be implemented.

Methodology: This was a retrospective descriptive study conducted in the Department of Obstetrics and Gynecology university teaching hospital (ULTH) from June 2019 of May 2021. The WHO criteria for near miss cases were used. The data of near-miss cases and mortality cases reviewed on a specially designed proforma. Data was analyzed, frequency and percentage charts were made for data analysis using SPSS version 21.

Results: There was a total number of 1,873 live births and out of them, 48 (2.56%) cases were of near miss and 2 (0.10%) was maternal mortality. The major causes of near-miss cases were severed preeclampsia (31%), postpartum hemorrhage (22.9%), puerperal sepsis (22%) eclampsia (18.7%) and ruptured uterus (2%). Majority of cases 83% never had no antenatal checkup and belonged to poor socioeconomic class (62.5%). Massive transfusion (29%), invasive ventilation (8%), obstetrical hysterectomy (6%), and renal failure (2%), were among the severe maternal morbidities.

Conclusion: Maternal-near miss is a good indicator of the obstetric care a woman receives in a healthcare system. Poor socioeconomic status and unable to book for antenatal care were observed to be the near miss contributor. Awareness about the need for a routine antenatal checkup and free medical care can be a solution. This may require commitment at the government level so that every mother can have a safe childbirth experience.