The prevalence of maternal near miss associated with ectopic pregnancy was comparable with observations from iran. Severe hypertensive disorders were the main cause of severe maternal morbidity 67069555. Evaluation of nearmiss maternal mortality is a robust surveillance method to assess the quality of obstetric care and determinants of poor maternal outcome. Based on that, who is conducting a large multicountry study with the main objectives of determining the prevalence of maternal nearmiss cases in health facilities, evaluating the quality of care using the maternal nearmiss concept and the criterionbased clinical audit, and developing the nearmiss concept in neonatal health. Maternal nearmiss and mortality in sayaboury province. Research article incidence and correlates of maternal near. Objective to evaluate the validity of whos nearmiss approach in a lowresource, high maternal mortality setting.
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. Mrc maternal and infant health care strategies research unit, university of pretoria, gauteng, south africa. Prevalence of maternal near miss and communitybased risk. Pdf on jan 1, 2014, babusha ayele and others published prevalence of maternal near miss and maternal death in atat hospital, ethiopia. Five hundred and one cases of maternal near miss and 19,908 live births occurred in the study period, yielding a maternal near miss ratio of 25. Maternal mortality and nearmiss index reflect the quality of care provided by a health facility.
Of women who experienced the direct causes, 435 died which means there were 67,567 maternal near miss cases. 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. In total, 21,579 live births, 395 women with severe maternal morbidity, 47 women with maternal near miss and two maternal deaths were analysed. The world health organization multicountry survey on. Maternal near miss can be a proxy for maternal death and it describes women who nearly died due to obstetric complications.
Maternal near miss and maternal deaths in mozambique. To determine the prevalence of severe acute maternal morbidity samm worldwide near miss. Incidence of maternal near miss among women in labour admitted to. Maternal near miss and mortality in a tertiary care. A pretested structured questionnaire was adapted with some modifications to interview 1,000 women. Near miss obstetric events and maternal deaths in a. Certain maternal near miss indicators have been suggested to evaluate the qualityofcare. It is defined as the sum of cases of maternal nearmiss and potentially lifethreatening conditions pltcs. Maternal near miss is defined as a severe life threatening obstetric complication necessitating an urgent medical interventions which leads to death if treatment is not initiated timely 1, 2.
Maternal mortality and near miss index reflect the quality of care provided by a health facility. Methods a crosssectional research design employing multistage sampling collected data from women aged 1549 years in rakai, uganda, who had been pregnant in the 3 years preceding the survey, conducted between. The severe maternal morbidity incidence ratio was 18. It measures life threatening pregnancy related complications and allows the assessment of the quality of obstetric care. Background lifethreatening events during pregnancy are currently used as a measure to assess quality of obstetric care. Incidence of maternal near miss among women in labour. The maternal near miss incidence ratio with who approach. Bjog, 2018 estimated the incidence of nearmisses in ghana, as well as determined factors associated with a nearmiss methods. The search strategy focused on three key words or phrases. The fulltext articles were read to confirm eligibility and to collect relevant information from the selected abstracts. There were 7390 deliveries and 1 near miss cases during the study period. The aim of this study is to assess prevalence of near miss cases and maternal deaths, to elucidate the causes and to analyze avoidable factors based upon the threedelays approach in southern mozambique.
This resulted in maternal nearmiss and mortality rates of 94. To evaluate nearmiss maternal mortality, we examined patient characteristics and maternal and neonatal outcomes for an obstetric population admitted to intensive care units icus in a tertiary care center. Pdf prevalence of maternal near miss and maternal death in atat. The main objectives of this study are to determine the prevalence of maternal nearmiss cases in a worldwide network of health facilities, evaluate the quality of care using the maternal nearmiss concept and the criterionbased clinical audit, and explore the use. Severe acute maternal morbidity and maternal deaths. Based on that, who is conducting a large multicountry study with the main objectives of determining the prevalence of maternal near miss cases in health facilities, evaluating the quality of care using the maternal near miss concept and the criterionbased clinical audit, and developing the near miss concept in neonatal health. This observation is similar to another study carried out in pakistan11. Application of the nearmiss approach at the health district or health system level 15. In 2004, who published a manual under the title beyond the numbers.
To examine the prevalence of maternal nearmiss mnm and its associated risk factors in a community setting in central uganda. Maternal near miss conditions were defined based on say et al. Fetal and neonatal deaths among cases of maternal near miss. Validity of whos nearmiss approach in a high maternal. The fulltext articles were read to confirm eligibility and to collect relevant information from.
Severe maternal morbidity and near misses in tertiary. We restricted the search to published articles in english language. Background severe maternal morbidity or near miss is a promising indicator to improve quality of obstetric care. A prospective descriptive study was carried out from october 1 2016 to 31 december 2016, using the who criteria for maternal near miss at. Incidence of maternal near miss in the public health sector of harare. From a global perspective, iran has been notably successful in reducing maternal mortality. Who who maternal death and nearmiss classifications.
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. 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. The following maternal near miss mnm indices were calculated. Near miss events frequency and most common causes 922 p j m h s vol. This study aimed to determine the burden of maternal nearmiss and maternal deaths in sayaboury province, lao pdr.
It is an estimation of the amount of care and resources that would be needed in an area or facility. Poisson multiple regression analysis was also performed. Practical criteria for maternal near miss needed for low. Traditionally, the analysis of maternal deaths has been the criteria of choice for evaluating womens health and the quality of obstetric care. For every maternal death, there are many women who experience morbidity objective. Magnitude of maternal near misses and the role of delays. The prevalence of severe maternal morbidity and near miss. Maternal nearmiss mnm incidence is the indicator reflecting maternal healthcare services. Maternal near miss mnm cases experience longterm physical and psychological effects.
This study investigated the prevalence of samm and nm cases and the associated risk factors in two reference maternity hospitals in a capital city in northeastbrazil. In this paper, we present the methods of the world health organization multicountry survey on maternal and newborn health. Incidence and determinants of severe maternal morbidity. Population all women, pregnant or until 42 days after the end of pregnancy, admitted at mnazi mmoja hospital, the tertiary. The investigation of severe maternal morbidity samm and maternal near miss nm and associated risk factors is important for the global reduction of maternal mortality. Maternal near miss among women using the public health. While maternal mortality rates may decline, nearmisses which outnumber mortality may still be high data is limited in lowincome countries like ghana with respect to actual nearmisses and underlying causes oppong et al. Pdf prevalence of maternal near miss and maternal death. Maternal near miss mnm is one of the important criteria for checking the quality of care in maternal health. Evaluatin h alit ar o ever regnanc omplication the who nearmiss approach for maternal health 5 1. With this tool, we will be able to identify the delays during the. The world health organization recently published nearmiss approach where strict near miss. The methodology followed a predefined protocol, an extensive search strategy of 10 electronic databases as well as other sources.
Full text severe maternal morbidity nearmiss and its correlates in. Setting mnazi mmoja hospital, the main referral hospital of zanzibar, tanzania, from 1 april 2017 until 31 december 2018. Reviews of such cases are considered a less threatening approach to improve maternal health care by the service providers. Maternal near miss and death among women with severe. The prevalence of severe maternal morbidity and near miss and associated factors in sergipe, northeast brazil. The who nearmiss approach for maternal health service. Pdf on jan 1, 2014, babusha ayele and others published prevalence of maternal near miss and maternal death in atat hospital, ethiopia find, read and cite all the research you need on researchgate. Jonathan spector expresses concern related to the applicability in poorresource settings of the criteria developed by who for identifying maternal near miss. The world health organization recently published near miss approach where strict near miss. In the same year, 323,824 live births were reported in hospitals, making the crude maternal near miss incidence ratio of 20. Pdf the prevalence of severe maternal morbidity and near. Managementbased criteria were the most common events for nm 87. Incidence of maternal near miss in the public health.
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