Incidence of maternal near miss among women in labour. A descriptive study was done in a cohort of 1215 pregnant women, who had their last normal menstrual period lmp between 1 august and 31 december, 2010. There were 7390 deliveries and 1 near miss cases during the study period. Effectiveness of the facilitybased maternal nearmiss case. Sep 30, 2018 all cases of severe maternal outcome smo. In an observational crosssectional study performed between january. The objective of this study was to assess the frequency of mnm in eastern ethiopia using an adapted subsaharan africa mnm tool and compare its applicability with the original who mnm tool. Background with the reduction of maternal mortality, maternal near miss mnm has been used as a complementary indicator of maternal health. For every maternal death, there are many women who experience morbidity objective. Assessment of maternal near miss at debre markos referral. For monitoring the level of obstetric healthcare, who recommends investigating near miss cases as a benchmark. Who who maternal death and nearmiss classifications. The world health organization defines a maternal near miss case as a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of the end of a. Maternal nearmiss is a serious life event, in which a birthing person comes close to death due to a significant health problem.
However, there is still controversy regarding the criteria for identification of near miss maternal morbidity. Maternal nearmiss and mortality in sayaboury province. Miss and maternal death survey, a nationwide, multicentre, cross. With this tool, we will be able to identify the delays during the. Severe maternal morbidity nearmiss and its correlates in the worlds newest nation. Maternal near miss among women using the public health. Measuring maternal near miss in a middleincome country. The world health organization defines a maternal nearmiss case as a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of the end of a. Results during the oneyear period, there were a total of 238 maternal nearmiss cases and 29,697 live births in all participating hospitals, which provides a maternal nearmiss incidence ratio of. Bmc pregnancy and childbirth maternal near miss and mortality in a tertiary care hospital in rwanda stephen rulisa 0 immaculee umuziranenge 2 maria small 1 jos van roosmalen 2 3 0 department of obstetrics and gynecology, university of rwanda, kigali, rwanda 1 department of obstetrics and gynecology, duke university, durham, nc, usa 2 department of obstetrics, leiden. This study aimed to determine the burden of maternal nearmiss and maternal deaths in sayaboury province, lao pdr. Of women who experienced the direct causes, 435 died which means there were 67,567 maternal near miss cases. Traditionally, the analysis of maternal deaths has been the criteria of choice for evaluating womens health and the quality of obstetric care. Near miss obstetric events and maternal deaths in a.
Maternal near misses are more common than deaths and statistically stronger for a comprehensive analysis of the determinants. Cases of nearmiss occur in larger numbers than maternal deaths it has been estimated that up to 9 million women survive obstetric complications every year. Women who experienced and survived a severe health condition during pregnancy, childbirth or postpartum are considered as near miss or severe acute maternal. Routine use of the maternal near miss process for assessing obstetric care is feasible if the collection of cases of women with maternal near miss are incorporated through the facilities severe adverse events committees or other similar structures. Mrc maternal and infant health care strategies research unit, university of pretoria, gauteng, south africa. Maternal nearmiss in labor and delivery in the light of. Cases of near miss occur in larger numbers than maternal deaths it has been estimated. Near miss criteria were in vogue for some years, yet lack of uniformity was the hindrance. Maternal near miss mnm is one of the important criteria for checking the quality of care in maternal health. To explore the epidemiological aspects, to describe the frequency and distribution of who maternal near miss mnm criteria and the presence of organ dysfunction and failure measured by the maximum sofa sequential organ failure assessment score sofa max in cases of severe maternal outcome smo. Certain maternal near miss indicators have been suggested to evaluate the qualityofcare. Maternal health indicators including obstetric complications, maternal deaths and births conducted at all hospitals available in ethiopia were included.
Maternal nearmiss incidence ratioit refers to the number of maternal nearmiss cases per live births. Out of total 937 pregnant women, there was a significant association between state of residence and development of pltc. With this tool, we will be able to identify the delays during the near miss and thereafter and take corrective action. The maternal near miss incidence ratio, which is the number of near miss cases per. Appropriate criteria for identification of nearmiss maternal. Incidence of smo, health service events, case fatality rate, and mortality index % of maternal deathsmo. However, there is still controversy regarding the criteria for identification of nearmiss maternal morbidity. Maternal nearmiss and death and their association with caesarean section complications. A oneday training programme on mnm was conducted at four family welfare training centres in the state of maharashtra, india, for the health service providers, viz. It is designed for hospital staff involved in maternal and newborn health care, programme managers and policymakers who. Evaluatin h alit ar o ever regnanc omplication the who nearmiss approach for maternal health 5 1. Pdf maternal nearmiss and death and their association with. Maternal near miss and death and their association with caesarean section complications. Maternal near miss is a serious life event, in which a birthing person comes close to death due to a significant health problem.
In the same year, 323,824 live births were reported in hospitals, making the crude maternal near miss incidence ratio of 20. We performed a cross sectional study of all women admitted to the tertiary care university hospital in kigali with severe near miss maternal morbidity and mortality during a one year period using the who criteria for. By evaluating these cases with severe maternal outcomes both nearmiss cases and maternal deaths, much can be learnt about the processes in place or lack. The world health organization has carried a broad international consultation and in 2009 defined the term maternal near miss. Severe acute maternal morbidity and maternal deaths. Dec 01, 2003 their group collected all maternal deaths and near misses due to hypertension in pregnancy from a clearly defined area in kwazulunatal south africa. Exploring epidemiological aspects, distribution of who.
It is an estimation of the amount of care and resources that would be needed in an area or facility. Maternal near miss guidelines is designed for the program managers at different levels of public health provide quality services and identify the best practices. To assess the prevalence of pregnancy complications identified as maternal near miss mnm and associated factors among women using the public health care system in the amazon and northeast regions of brazil. To determine the prevalence and factors associated with severe near miss maternal morbidity and mortality in the university teaching hospital of kigali rwanda. Methods we applied the subsaharan africa and who mnm criteria to. Selfappraisal of maternal near miss, their perception of the quality of care, their predisposition to seek healthcare and the social support received were the four major themes that emerged from the experiences and perceptions of women with maternal near miss. Maternal near miss refers to situations where women experience severe lifethreatening obstetric complications during pregnancy, delivery or post pregnancy which they survive either by chance or because they receive good care at a facility.
Certain maternal near miss indicators have been suggested to evaluate the quality of care. Three different approaches were in use to identify maternal near miss cases. The study of severe maternal morbidity survivors near miss may be an alternative or a complement to the study of maternal death events as a health care indicator. Distant and proximate factors associated with maternal near. Maternal near miss case is defined as a woman who nearly died but survived a complication that occurred during pregnancy, childbirth, or within 42 days of termination of pregnancy. Appropriate criteria for identification of nearmiss. Study of near miss cases in obstetrics and maternal. The following maternal near miss mnm indices were calculated. Impact of training on awareness and knowledge of service. Pdf maternal near miss and maternal death in the world. Maternal mortality and nearmiss in rural north india. Evaluation of maternal near miss cases at a tertiary care. Severe acute maternal morbidity near miss international. A significant association between maternal outcome and age of study population was found.
We had also observed the trend of near miss events and maternal deaths in one year. The study aimed to identify the factors associated with maternal near miss in selected public hospitals of addis ababa, ethiopia. Despite significant movements over the past decades, maternal health has been still considered as a central goal for sustainable development. Practical criteria for maternal near miss needed for lowincome. To improve the awareness and knowledge regarding maternal near miss mnm among health service providers in the selected districts and womens hospitals in maharashtra, india. Pdf demographic determinants of maternal nearmiss cases. Certain maternal nearmiss indicators have been suggested to evaluate the quality of care.
Pdf maternal near miss and mortality in a tertiary care hospital in rwanda stephen rulisa academia. Maternal near miss is defined as an event in which a pregnant or recently delivered woman survived a complication either during pregnancy, childbirth or 42 days after termination of pregnancy. Jan 27, 2018 ethiopia is one of the subsaharan africa countries with the highest maternal mortality. The maternal near miss incidence ratio with who approach. Making maternal near miss audits operational in monitoringevaluating quality of obstetric care. Methods studies were searched for in six electronic databases medline. Their group collected all maternal deaths and near misses due to hypertension in pregnancy from a clearly defined area in kwazulunatal south africa. Introduction progress in the reduction of maternal mortality a key millennium development goal has been slow in most countries that have high maternal mortality ratios, and solutions to this global problem are urgently needed 1. Cases of nearmiss occur in larger numbers than maternal deaths it has been estimated. World health organization defines maternal near miss.
Maternal nearmiss refers to situations where women experience severe lifethreatening obstetric complications during pregnancy, delivery or post pregnancy which they survive either by chance or because they receive good care at a facility. Methods we applied the subsaharan africa and who mnm criteria. Maternal near miss mnm has emerged as an adjunct to the investigation of. Maternal near miss and maternal death in the world health organizations 2005 global survey on maternal and perinatal health. In the cases of maternal death 50% of the death occurred in women with.
Distant and proximate factors associated with maternal. To present a clear portrait of the current situation, we. Improving the maternal health is one of the worlds most challenging problems. Full text severe maternal morbidity nearmiss and its correlates in. Aug 25, 2015 maternal near miss guidelines is designed for the program managers at different levels of public health provide quality services and identify the best practices. Maternal nearmiss in a rural hospital in sudan the first report of maternal nearmiss in sudan medical files of pregnant women and who delivered recently at kassala maternity hospital from january 2008 to december 2010 were studied. The study aimed to identify the factors associated with maternal nearmiss in selected public hospitals of addis ababa, ethiopia. In several countries this approach has been introduced and supported by who and partners since 2004, but information on the quality of its implementation is missing. Maternal near miss and predictive ability of potentially. The women with maternal near miss viewed their experiences. Childbirth trauma and maternal nearmiss 4th trimester project. Maternal near miss mnm cases experience longterm physical and psychological effects. Pdf who maternal death and nearmiss classifications. Our second objective was to analyse the nature of near miss events and compare the causes of near miss cases with that of maternal mortality.
Standard criteria for identifying near near miss cases were developed and then validated in various countries. This group is specifically for maternal nearmiss survivors. This study aimed to characterize the near miss maternal morbidity according to different sets of criteria. Maternal near miss, maternal near miss events, maternal death 1. South sudan fekadu mazengia alemu,1 martina c fuchs. Pdf maternal near miss and mortality in a tertiary care. Maternal near miss and maternal death in the world health. Mortality indexit is the number of maternal deaths divided by the number of women with lifethreatening conditions, expressed as a percentage. Maternal nearmisses are more common than deaths and statistically stronger for a comprehensive analysis of the determinants. Maternal near miss and mortality in a tertiary care. Childbirth trauma and maternal nearmiss 4th trimester. Thus investigating severe maternal morbidity nearmiss helps to identify women at highest risk of maternal death and helps allocate resources especially in the.
Measuring maternal nearmiss in a middleincome country. Analysis of nearmiss and maternal mortality at tertiary. The experiences of women with maternal near miss and their. Maternal near miss and maternal death in the world health organizations 2005 global survey on maternal and perinatal health joao paulo souza,a jose guilherme cecatti,b anibal faundes,b sirlei siani morais,b jose villar,c guillermo carroli,d metin gulmezoglu,a daniel wojdyla,d nelly zavaleta,e allan donner,f alejandro velazco,g vicente. Results during the oneyear period, there were a total of 238 maternal near miss cases and 29,697 live births in all participating hospitals, which provides a maternal near miss incidence ratio of.
Research article open access maternal nearmiss and. Effectiveness of the facilitybased maternal nearmiss. Introduction maternal near miss is said to be occurred when women presented with life threatening complication during pregnancy, child birth and within 42 days after delivery, but survive by chance or good institutional care. Reviews of such cases are considered a less threatening approach to improve maternal health care by the service providers. This group is specifically for maternal near miss survivors. Study of near miss cases in obstetrics and maternal mortality. The who nearmiss approach for maternal health service.
Pdf maternal nearmiss and death and their association. Ethiopia is one of the subsaharan africa countries with the highest maternal mortality. Maternal near miss and mortality in a tertiary care hospital. Sep 11, 2007 the study of severe maternal morbidity survivors near miss may be an alternative or a complement to the study of maternal death events as a health care indicator.
Maternal nearmiss mnm incidence is the indicator reflecting maternal healthcare services. Maternal near miss towards a standard tool for monitoring. They also collected a control group of two pregnant women with hypertension per near miss or maternal death from the same area, delivered on the same day and matched for age and parity. Maternal near miss geneva foundation for medical education and. Pragmatic criteria are related to severe maternal morbidity near miss.
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