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. 2016 Oct;66(Suppl 1):315-20.
doi: 10.1007/s13224-016-0901-3. Epub 2016 Jun 13.

Incidence of Maternal "Near-Miss" Events in a Tertiary Care Hospital of Central Gujarat, India

Niyati T Parmar  1 , Ajay G Parmar  1 , Vihang S Mazumdar  1
Affiliations

Incidence of Maternal "Near-Miss" Events in a Tertiary Care Hospital of Central Gujarat, India

Niyati T Parmar et al. J Obstet Gynaecol India. 2016 Oct.

Abstract

Background: Constant decline in maternal mortality ratio has given rise to the need of a new indicator. This search has motivated investigation of severe maternal morbidity-"maternal near-miss" (MNM) event. World Health Organization (WHO) defines MNM 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".

Methodology: A hospital-based cross-sectional study was carried out at Sir Sayajirao General Hospital (SSGH), a tertiary care referral hospital in Vadodara, Central Gujarat, from May to September 2012. MNM events were identified according to either WHO or Mantel et al. criteria or both.

Results: During study period, 1929 live births, 18 maternal deaths and 46 "near-miss" cases were recorded. Among these 46 near-miss cases, 57 near-miss events were identified. Calculated MNM ratio was 23.85/1000 live births, MNM rate was 20.6/1000 obstetric admissions, the ratio of maternal death to MNM event was 1:2.6, and overall Mortality index was 28.1 %. Among near-miss cases, percentage of preterm delivery was 42 % and stillbirth rate was 35 % (16/46). Out of 46 MNM, pregnancies were continued in 3 while 43 pregnancies were terminated. (25 live births, 16 stillbirths, 2 abortions).

Conclusion: Identification of preventable factors and special preventive actions should be taken for management of complications in such near-miss cases.

Keywords: Central Gujarat; Government hospital; Maternal mortality; Maternal near-miss (MNM).

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Conflict of interest statement

Dr. Niyati Parmar declares that she has no conflict of interest. Dr. Ajay Parmar declares that he has no conflict of interest. Dr. Vihang Mazumdar declares that he has no conflict of interest. Ethical Approval Before starting enrolment of the participants, necessary clearances and permissions were obtained from concerned authorities including Scientific and Ethical Research Committee (SERC) for Human research. Scanned copy of which has been attached here with in additional document. Informed Consent At the time of data collection, the purpose of the study was clearly explained to the study subjects and they were also assured of the confidentiality of the information. The study subjects were enrolled in the study only after taking written informed consent.

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