Retrospective review of maternal deaths and maternal near misses due to major obstetric haemorrhage at a tertiary care centre in India
Loading...
Date
2019-08
Journal Title
Journal ISSN
Volume Title
Publisher
Medip Academy
Abstract
Background: Maternal near miss (MNM) is now widely accepted as a better indicator of maternal health than maternal death and reflects the quality of obstetric care in a particular institution.Methods: This is a retrospective study conducted at Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital over a period of 12 months (April 2016-March 2017), of all cases of maternal death and near miss maternal deaths due to major obstetric haemorrhage(MOH).Results: During the period reviewed, there were 13,083 deliveries, 12,958 live births and 37 maternal deaths. There were 30 cases of near miss maternal deaths and 2 maternal mortalities due to MOH. The mortality index was 6.25%. Severe maternal outcome ratio (SMOR) was 2.46.Among the near miss cases (n=30), morbidly adherent placenta was the cause in 26.6% of cases(n=8), postpartum hemorrhage in 23% of cases(n=7); rupture uterus in 13% cases(n=4); massive abruption in 13% of cases(n=4) and placenta praevia with antepartum haemorrhage in 3% of cases(n=1). Early obstetric haemorrhage due to ruptured ectopic pregnancy and incomplete abortion resulted in MNM in 16% (n=5) and 3.3% (n=1) cases respectively.It was observed that in 40% (n=12) of MNM cases (8 cases of morbidly adherent placenta plus 4 cases of rupture uterus), previous cesarean section was the single most important causative factor for the morbidity of the patient.Conclusions: Reduction in cesarean section rates is imperative to reduce morbidity and mortality associated with MOH.
Description
Keywords
Cesarean section, Major obstetric haemorrhage, Maternal near miss, Mortality index
Citation
Agrawal Swati, Singh Anuradha, Biswas Ratna, Singh Abha. Retrospective review of maternal deaths and maternal near misses due to major obstetric haemorrhage at a tertiary care centre in India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2019 Aug; 8(8): 3431-3434