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A Study of Maternal-Near-Miss(Mnm) at A District Teaching Hospital” - A Retrospective Observational Study

, Harsha T.N. , Damayanthi H.R.

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Indian Journal of Obstetrics and Gynecology 5(3 (Supplement)):p 308-308, Jul-Sep 2017. | DOI:

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Abstract

Maternal health is an integral part of health care system. Maternal mortality is an indicator of maternal health. Severe morbid conditions require comprehensive approach. Hence the concept of Maternal-Near-Miss (MNM) has emerged. Aims and Objectives: To identify and analyse the (i) Strategies undertaken in the management of Maternal- Near-Miss (MNM) and outcome (ii) Measures to improve the quality of care. Materials and Methods: A retrospective observational study for the period January 2016 to December 2016 at District Teaching Hospital, Kodagu Institute of Medical Sciences, Madikeri, by collecting data from hospital records. Results: In our study, there were 25 Maternal-Near- Miss(MNM) cases and four maternal deaths out of 3347 live births giving a maternal mortality ratio of 119/100,000 live births(LB), maternal near miss ratio of 7.46/1000LB, MNM:1MD ratio is 6.25 and mortality index(MI) is 13.79%. 25 cases of obstetric emergencies with serious concerns for maternal health were selected out of 97 cases who met the WHO criteria for MNM (25.77%). 12 cases(48%) received multiple blood-transfusion,8 cases(32%) of sepsis, 7 cases (28%) of PPH, and 5 cases(20%) of hypertensive disorder of pregnancy (pre-eclampsia, eclampsia). There were 12 cases (48%) that had more than one inclusion criteria. Surgical intervention(s) were required in 8 cases (32%) i.e. 2 peripartum hysterectomies, 2 laparotomies, 1 MRP, 1 uterine reposition and 2 traumatic PPH repair. Conclusion: Maternal-Near-Miss (MNM/SAMM) and its relation to maternal mortality contribute as sensitive measures of pregnancy outcome than mortality alone. Proper documentation is of paramount importance in analysis of data, to make conclusions and recommendation. Prospective structured study is required to get a clear picture and to suggest corrective measures which can be taken as far as obstetric care is concerned, to reduce maternal mortality and to achieve the Sustainable Developmental Goal (SDG) by 2030.

Keywords: Maternal Near Miss; SAMM; Maternal Mortality.

  

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