Near Miss and Maternal Mortality at the Jos University Teaching Hospital.

Abstract

Background: Some women who enter pregnancy in a healthy state may survive with serious complications while others may die. This study sets out to determine the frequency of maternal near-miss (MNM) and maternal death. It also intended to identify common causes and determinants.

Materials and methods: This was a cross-sectional study from June 2012 to May 2013 that involved women who were admitted for delivery, within 42 days of delivery or termination of pregnancy and those who died from pregnancy, childbirth, or puerperal complications. Data obtained were analyzed using Epi info 2002.

Results: There were 105 maternal near misses and deaths. Nineteen of them were mortalities, whereas 86 were MNMs. The maternal mortality ratio over the period was 806/100,000 live births and near miss was 3649/100,000 live birth. Hypertensive disorders in pregnancy were the leading cause of maternal deaths (47.36%) and MNMs (47.7%). Maternal deaths (57.9%) and near misses (43%) were the highest among those that treatment was instituted after 60 min and within 30-60 min of diagnosis, respectively. The consultants were the highest level of expertise involved in the management of 73.3% and this group recorded the least maternal death and highest MNM.

Conclusion: Hypertensive disorder was the leading cause of MNM and mortality. Involving the highest level of expertise in patient management and reducing the time interval between diagnoses and instituting definitive treatment is essential for a better outcome. Health institutions will benefit from the evaluation of their quality of obstetric care by including near miss investigations in their maternal death enquiries.