Maternal Near Miss: A Valuable Contribution in Maternal Care

BACKGROUND: MMR has always been recognized as an important indicator of quality of health services. The MMR in India has so far not reached up to the required MDG 2015. If we look into this matter with the eagle's eye view, then there are certain gray areas which need attention. For this, it is not the maternal mortality but the maternal near miss which has to be focused. OBJECTIVES: To audit the maternal near miss in our institution and to review the pathways that lead to severe maternal morbidity and death. METHODS: Prospective observational study from September 2013 to August 2015 in Dr. Bhim Rao Ambedkar Memorial Hospital, Raipur. Maternal near miss cases were identified based on WHO criteria 2009, recorded, and studied. RESULTS: There were 13,895 live births, 211 maternal near miss, and 102 maternal deaths. Maternal near miss to mortality ratio was 2:1. Maternal near miss incidence ratio was 15.18/1000 live births. Mortality index was 32.58 %. Hemorrhage and hypertensive disorders of pregnancy toped the list of the leading causes of near miss morbidity. The near miss events were more common in the primipara (39 %), with age group 21-30 years and in the third trimester at the time of admission. CONCLUSION: Auditing maternal near miss can help in reducing their morbidity and mortality in our institution. Similar audit between other institute, state, and countries may help to hasten the slow progress of reducing maternal mortality.