Maternal near miss and maternal death in the world health organizations 2005 global survey on maternal and perinatal health joao paulo souza,a jose guilherme cecatti,b anibal faundes,b sirlei siani morais,b jose villar,c guillermo carroli,d metin gulmezoglu,a daniel wojdyla,d nelly zavaleta,e allan donner,f alejandro velazco,g vicente. Maternal health indicators including obstetric complications, maternal deaths and births conducted at all hospitals available in ethiopia were included. Near miss criteria were in vogue for some years, yet lack of uniformity was the hindrance. Mortality indexit is the number of maternal deaths divided by the number of women with lifethreatening conditions, expressed as a percentage.
Maternal near miss, maternal near miss events, maternal death 1. Pdf maternal nearmiss and death and their association with. Maternal nearmiss and death and their association with caesarean section complications. Pdf maternal nearmiss and death and their association. Improving the maternal health is one of the worlds most challenging problems. Severe acute maternal morbidity near miss international. This study aimed to determine the burden of maternal nearmiss and maternal deaths in sayaboury province, lao pdr. Maternal near miss mnm has emerged as an adjunct to the investigation of. The world health organization defines a maternal near miss case as a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of the end of a. Sep 11, 2007 the study of severe maternal morbidity survivors near miss may be an alternative or a complement to the study of maternal death events as a health care indicator. This study aimed to characterize the near miss maternal morbidity according to different sets of criteria. Miss and maternal death survey, a nationwide, multicentre, cross. Standard criteria for identifying near near miss cases were developed and then validated in various countries. Maternal mortality and nearmiss in rural north india.
With this tool, we will be able to identify the delays during the. South sudan fekadu mazengia alemu,1 martina c fuchs. The world health organization defines a maternal nearmiss case as a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of the end of a. Maternal nearmiss mnm incidence is the indicator reflecting maternal healthcare services. Jan 27, 2018 ethiopia is one of the subsaharan africa countries with the highest maternal mortality. Maternal near miss and death and their association with caesarean section complications. Childbirth trauma and maternal nearmiss 4th trimester. Who who maternal death and nearmiss classifications.
To determine the prevalence and factors associated with severe near miss maternal morbidity and mortality in the university teaching hospital of kigali rwanda. To improve the awareness and knowledge regarding maternal near miss mnm among health service providers in the selected districts and womens hospitals in maharashtra, india. Distant and proximate factors associated with maternal. Study of near miss cases in obstetrics and maternal mortality. Despite significant movements over the past decades, maternal health has been still considered as a central goal for sustainable development. A oneday training programme on mnm was conducted at four family welfare training centres in the state of maharashtra, india, for the health service providers, viz. Maternal near miss and mortality in a tertiary care hospital. Childbirth trauma and maternal nearmiss 4th trimester project. Three different approaches were in use to identify maternal near miss cases. Effectiveness of the facilitybased maternal nearmiss. The experiences of women with maternal near miss and their. Certain maternal near miss indicators have been suggested to evaluate the qualityofcare. We had also observed the trend of near miss events and maternal deaths in one year. The maternal near miss incidence ratio with who approach.
Reviews of such cases are considered a less threatening approach to improve maternal health care by the service providers. Mrc maternal and infant health care strategies research unit, university of pretoria, gauteng, south africa. Pdf maternal near miss and mortality in a tertiary care hospital in rwanda stephen rulisa academia. They also collected a control group of two pregnant women with hypertension per near miss or maternal death from the same area, delivered on the same day and matched for age and parity. The study of severe maternal morbidity survivors near miss may be an alternative or a complement to the study of maternal death events as a health care indicator. Maternal near miss is defined as an event in which a pregnant or recently delivered woman survived a complication either during pregnancy, childbirth or 42 days after termination of pregnancy. Routine use of the maternal near miss process for assessing obstetric care is feasible if the collection of cases of women with maternal near miss are incorporated through the facilities severe adverse events committees or other similar structures. The world health organization has carried a broad international consultation and in 2009 defined the term maternal near miss. A significant association between maternal outcome and age of study population was found. The who nearmiss approach for maternal health service. Maternal near miss among women using the public health. Practical criteria for maternal near miss needed for lowincome. Assessment of maternal near miss at debre markos referral.
Ethiopia is one of the subsaharan africa countries with the highest maternal mortality. Appropriate criteria for identification of nearmiss maternal. The following maternal near miss mnm indices were calculated. Pdf maternal near miss and mortality in a tertiary care. By evaluating these cases with severe maternal outcomes both nearmiss cases and maternal deaths, much can be learnt about the processes in place or lack. Incidence of maternal near miss among women in labour. Maternal near miss and maternal death in the world health organizations 2005 global survey on maternal and perinatal health. Maternal nearmiss is a serious life event, in which a birthing person comes close to death due to a significant health problem. Cases of nearmiss occur in larger numbers than maternal deaths it has been estimated that up to 9 million women survive obstetric complications every year.
Maternal near miss and predictive ability of potentially. Methods we applied the subsaharan africa and who mnm criteria to. Background with the reduction of maternal mortality, maternal near miss mnm has been used as a complementary indicator of maternal health. In several countries this approach has been introduced and supported by who and partners since 2004, but information on the quality of its implementation is missing. 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.
Cases of nearmiss occur in larger numbers than maternal deaths it has been estimated. Maternal near miss case is defined as a woman who nearly died but survived a complication that occurred during pregnancy, childbirth, or within 42 days of termination of pregnancy. 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. Maternal nearmiss in a rural hospital in sudan the first report of maternal nearmiss in sudan medical files of pregnant women and who delivered recently at kassala maternity hospital from january 2008 to december 2010 were studied. Women who experienced and survived a severe health condition during pregnancy, childbirth or postpartum are considered as near miss or severe acute maternal. For every maternal death, there are many women who experience morbidity objective. Pragmatic criteria are related to severe maternal morbidity near miss. Maternal near miss geneva foundation for medical education and. Certain maternal nearmiss indicators have been suggested to evaluate the quality of care. Traditionally, the analysis of maternal deaths has been the criteria of choice for evaluating womens health and the quality of obstetric care. In an observational crosssectional study performed between january.
This group is specifically for maternal nearmiss survivors. Making maternal near miss audits operational in monitoringevaluating quality of obstetric care. It is an estimation of the amount of care and resources that would be needed in an area or facility. Methods studies were searched for in six electronic databases medline. With this tool, we will be able to identify the delays during the near miss and thereafter and take corrective action. Maternal near miss guidelines is designed for the program managers at different levels of public health provide quality services and identify the best practices. Pdf who maternal death and nearmiss classifications. Maternal nearmisses are more common than deaths and statistically stronger for a comprehensive analysis of the determinants. Maternal near miss refers to situations where women experience severe lifethreatening obstetric complications during pregnancy, delivery or post pregnancy which they survive either by chance or because they receive good care at a facility. The objective of this study was to assess the frequency of mnm in eastern ethiopia using an adapted subsaharan africa mnm tool and compare its applicability with the original who mnm tool. Maternal nearmiss in labor and delivery in the light of. Full text severe maternal morbidity nearmiss and its correlates in. In the same year, 323,824 live births were reported in hospitals, making the crude maternal near miss incidence ratio of 20.
Methods we applied the subsaharan africa and who mnm criteria. Results during the oneyear period, there were a total of 238 maternal near miss cases and 29,697 live births in all participating hospitals, which provides a maternal near miss incidence ratio of. Maternal near misses are more common than deaths and statistically stronger for a comprehensive analysis of the determinants. Pdf demographic determinants of maternal nearmiss cases. The maternal near miss incidence ratio, which is the number of near miss cases per. Their group collected all maternal deaths and near misses due to hypertension in pregnancy from a clearly defined area in kwazulunatal south africa. Impact of training on awareness and knowledge of service. Our second objective was to analyse the nature of near miss events and compare the causes of near miss cases with that of maternal mortality. However, there is still controversy regarding the criteria for identification of nearmiss maternal morbidity. Maternal near miss and maternal death in the world health. Incidence of smo, health service events, case fatality rate, and mortality index % of maternal deathsmo. For monitoring the level of obstetric healthcare, who recommends investigating near miss cases as a benchmark. However, there is still controversy regarding the criteria for identification of near miss maternal morbidity. Thus investigating severe maternal morbidity nearmiss helps to identify women at highest risk of maternal death and helps allocate resources especially in the.
Results during the oneyear period, there were a total of 238 maternal nearmiss cases and 29,697 live births in all participating hospitals, which provides a maternal nearmiss incidence ratio of. It is designed for hospital staff involved in maternal and newborn health care, programme managers and policymakers who. 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. There were 7390 deliveries and 1 near miss cases during the study period. Distant and proximate factors associated with maternal near. Near miss obstetric events and maternal deaths in a.
The study aimed to identify the factors associated with maternal nearmiss in selected public hospitals of addis ababa, ethiopia. 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. Maternal nearmiss incidence ratioit refers to the number of maternal nearmiss cases per live births. Appropriate criteria for identification of nearmiss. Analysis of nearmiss and maternal mortality at tertiary. Exploring epidemiological aspects, distribution of who. Sep 30, 2018 all cases of severe maternal outcome smo. The study aimed to identify the factors associated with maternal near miss in selected public hospitals of addis ababa, ethiopia. Of women who experienced the direct causes, 435 died which means there were 67,567 maternal near miss cases.
Maternal near miss mnm cases experience longterm physical and psychological effects. To explore the epidemiological aspects, to describe the frequency and distribution of who maternal near miss mnm criteria and the presence of organ dysfunction and failure measured by the maximum sofa sequential organ failure assessment score sofa max in cases of severe maternal outcome smo. Effectiveness of the facilitybased maternal nearmiss case. Selfappraisal of maternal near miss, their perception of the quality of care, their predisposition to seek healthcare and the social support received were the four major themes that emerged from the experiences and perceptions of women with maternal near miss. To present a clear portrait of the current situation, we. Cases of near miss occur in larger numbers than maternal deaths it has been estimated. We performed a cross sectional study of all women admitted to the tertiary care university hospital in kigali with severe near miss maternal morbidity and mortality during a one year period using the who criteria for.
Maternal near miss is a serious life event, in which a birthing person comes close to death due to a significant health problem. World health organization defines maternal near miss. Certain maternal near miss indicators have been suggested to evaluate the quality of care. Dec 01, 2003 their group collected all maternal deaths and near misses due to hypertension in pregnancy from a clearly defined area in kwazulunatal south africa. Maternal near miss mnm is one of the important criteria for checking the quality of care in maternal health. Measuring maternal near miss in a middleincome country. Maternal nearmiss and mortality in sayaboury province. Out of total 937 pregnant women, there was a significant association between state of residence and development of pltc. Severe maternal morbidity nearmiss and its correlates in the worlds newest nation. Evaluation of maternal near miss cases at a tertiary care.
Study of near miss cases in obstetrics and maternal. The women with maternal near miss viewed their experiences. Maternal nearmiss refers to situations where women experience severe lifethreatening obstetric complications during pregnancy, delivery or post pregnancy which they survive either by chance or because they receive good care at a facility. Research article open access maternal nearmiss and.
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