Evaluation of Maternal Near Miss (MNM) Events and Maternal Mortality at Tertiary Care Hospital

Abstract

Maternal Near-Miss events are critical indicators of the quality of maternal healthcare, representing instances where women survive severe obstetric complications that could have resulted in death. Objectives: To find out the characteristics and causes of maternal near-miss events and maternal mortality at Liaquat University Hospital Hyderabad/Jamshoro. Methods: This cross-sectional study was conducted on 233 pregnant and postpartum women of were within 42 days of childbirth, who presented with severe morbidity or early maternal mortality. The duration of the study was from January 1 2021 to June 30 2021. Women undergoing uncomplicated cesarean sections or normal vaginal deliveries, as well as cases of mild anemia, mild-to-moderate hypertension, and Class I and II hemorrhages (less than 30% blood loss), were excluded. Data were collected on demographic characteristics and clinical details such as the mode of delivery, timing of near-miss events concerning admission, patient presentation, surgical interventions performed to save the mother's life, and obstetric complications. Results: The mean age of maternal near-miss cases was 25.5 ± 5.5 years. Most maternal near-miss cases occurred among multiparous, rural, un-booked women aged 26–30 years. The leading causes of maternal near-miss were hemorrhage (44.2%), hypertensive disorders (35.1%), and dystocia (12%), followed by sepsis and severe anemia (4.2% each). A significant proportion, 176 cases (75.5%), required intensive care unit admission, with a mean hospital stay of 14.5 days. Conclusions: It was concluded that hemorrhage and hypertensive disorder were found to be the most common causes of maternal near-miss cases.