Study of Maternal Near Miss Morbidity in a Tertiary Care Centre of Western Rajasthan

According to millennium development goals (MDG) in 2015, the goal number five was to improve the maternal health is falling way below our target. Our aim in reducing maternal mortality by 75% has not been met with MDG. Pregnant women?s health status is not reflected by mortality indicators alone hence the concept of severe acute maternal morbidity (SAMM) is an apt for the present health providing system. Main aims and objective of study were 1.To study the frequency of maternal near miss cases in Mathura Das Mathur hospital and Umaid hospital Jodhpur, tertiary care hospitals in Western Rajasthan. 2 .To calculate maternal near miss incidence ratio, maternal near miss to mortality ratio and mortality index. 3. To find out risk factors associated with near miss. METHODS : A retrospective analysis of data collected from April 2020 to September 2020 is done. Ours is a tertiary care centre covering area of Western Rajasthan , India. It is a referral centre for both private and public hospitals in Jodhpur and surrounding districts. Potentially life threatening conditions were diagnosed and those cases which met WHO 2009 criteria were selected. RESULTS:There were 11,157 deliveries in our hospital from April 2020 to September 2020. There were 9,832 live births ,208 maternal near miss cases and 14 maternal deaths.Most of the near miss cases were suffering from hypertensive disease of pregnancy. 61 cases was suffered from hemorrhage which include post partum and antepartum hemorrhage. 11 patients was having ruptured uterus with hemodynamically unstable. 10 patients was having ruptured ectopic pregnancy with hemoperitonium. 8 patients was having sepsis which included septic abortion and puerperal sepsis. CONCLUSIONS:In our study on evaluating the primary obstetric complication leading to MNM, hemorrhage and hypertensive disorders of pregnancy were the commonest complications associated with near miss as well as maternal death.