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. 2018 Jun 11;18(1):221.
doi: 10.1186/s12884-018-1862-6.

Maternal 'near miss' collection at an Australian tertiary maternity hospital

Skandarupan Jayaratnam  1 , Sonia Kua  2 , Caroline deCosta  3 , Richard Franklin  4
Affiliations

Maternal 'near miss' collection at an Australian tertiary maternity hospital

Skandarupan Jayaratnam et al. BMC Pregnancy Childbirth. .

Abstract

Background: Australia has a maternal mortality ratio of 6.8/100000 live births, a rate akin to other developed countries and consistent with the high level care provided within the Australian health care system. With maternal mortality at very low levels assessment of severe maternal morbidity is increasingly being used as an indicator of quality of care and to identify areas for improvement in maternity services. The WHO maternal 'near miss' criteria is a standardised tool has been increasingly used worldwide to assess maternal morbidity and standards of maternity care. The aim of this study was to determine the rate and aetiology of maternal 'near misses' at King Edward Memorial Hospital (KEMH) using the WHO near miss criteria.

Methods: Cases of maternal 'near miss' were prospectively identified at KEMH using the WHO near miss criteria over a period of 6 months (1st December 2014 to 31st May 2015). A descriptive analysis of the results was undertaken.

Results: During the study there were 2773 live births with 19 women who had 'near miss' presentations. There were no maternal deaths. The maternal 'near miss' index rate was 7/1000 live births. The main causes of obstetric 'near miss' were obstetric haemorrhage, pre-eclampsia and early pregnancy complications.

Conclusion: The rate of maternal 'near miss' at KEMH was 7/1000 live births and post-partum haemorrhage was identified as the most common aetiology, consistent with other studies in developed countries. Further research comparing currently utilised local, state and national morbidity systems would allow further validation of the WHO near miss criteria in Australian settings. The study presented in this publication was undertaken at King Edward Memorial Hospital, 374 Bagot Rd., Subiaco WA 6008.

Keywords: Maternal health; Maternal mortality; Near miss healthcare; Pregnancy complications; Severe maternal morbidity.

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Conflict of interest statement

Ethics approval and consent to participate

The ethics approval to undertake this study was provided by the Women and Newborn Health Service Human Research Ethics Committee and the Hospital Quality Improvement Committee at King Edward Memorial Hospital: Audit reference 2016166QK. The study was approved as a quality improvement audit and as this was an audit using case notes only and no interaction with patients, there was no need for patient consent.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Sources of Severe Maternal Morbidity Information in Australia. Adapted from Figure 1-Relationships between data collections included in the review in Maternity data in Australia: a review of sources and gaps. AIHW National Perinatal Epidemiology and Statistics Unit. Bulletin 87. September 2011
See this image and copyright information in PMC

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References

    1. Roser M. "Maternal Mortality". Published online at OurWorldInData.org. 2018. Retrieved from: https://ourworldindata.org/maternal-mortality.
    1. Humphrey MD. Maternal mortality trends in Australia. Med J Aust. 2016;205(8):344–346. doi: 10.5694/mja16.00906. - DOI - PubMed
    1. Johnson S, Sullivan E. Reporting maternal deaths in Australia. O & G Magazine. 2013;15(1):15–16.
    1. Say L, Souza J, Pattinson R. Maternal near-miss – towards a standard tool for monitoring quality of maternal health care. Best Pract Res Clin Obstet Gynaecol. 2009;23(3):287–296. doi: 10.1016/j.bpobgyn.2009.01.007. - DOI - PubMed
    1. Pattinson RC, Hall M. Near misses: a useful adjunct to maternal death inquiries. Br Med Bull. 2003;67:231–243. doi: 10.1093/bmb/ldg007. - DOI - PubMed

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