Magnitude, Pattern and Predictors of Maternal Near Miss Cases Admitted in a Tertiary Care Hospital.

Abstract

Maternal Near Miss is a serious antagonistic event that leads to harm and morbidity in the mother, but from which she survives. Maternal mortality rate in Bangladesh has declined by 66.0% over last few decades, valued at a rate of 5.5% every year. Aim of the study was to determine the magnitude, pattern and predictors of Maternal Near Miss cases. This cross-sectional descriptive type of observational study was conducted at the Department of Obstetrics and Gynecology in Mymensingh Medical College Hospital, Bangladesh from January 2018 to December 2018. A total of 69 patients were included for the study. Patients were evaluated for cardiac arrest, jaundice, gasping, shock coagulation disorders, cerebrovascular accident and total paralysis. Serum lactate >5mmol/L, paO₂/ FiO₂ <200mm of Hg, pH <7.1 and statistical analysis was performed using computer- based software, statistical package for social science (SPSS) version 20.0. Maximum number was found 44.93% in the age groups 20-29 years, maximum were rural patients (84.05%), no formal education (55.07%) of couple were significantly higher in case of maternal near miss case. Rate of maternal near miss case among the admitted patients was 4.86%. Among the maternal near miss case pregnancy induced hypertension were most common (44.9%). Most of the patients of the maternal near miss case presented with excessive P/V bleeding (37.7%). Among the medical management most common interventions were infusion of MgSO₄ (31.9%). Regarding neonatal outcome, live birth was 47.82%. Common causes of maternal near miss case are pregnancy induced hypertension, obstetric hemorrhage, ruptured uterus and ruptured ectopic pregnancy, prolonged/obstructed labor, impending uterine rupture and infections.