Maternal Near Miss in Al-Najaf Province; Causes and Prevalence; A cross-sectional Study

A maternal near miss, as defined by the World Health Organization (WHO), is a woman who has experienced a life-threatening situation and survived during pregnancy, labour, or the puerperium period.Maternal near miss is a more appropriate indicator of the quality of maternal health services than maternal death, as the former occurs more frequently than the latter. This allows for the identification of the factors that contribute to a fatal outcome, thereby facilitating the improvement of maternal health services.The objective of this study is to ascertain the prevalence and aetiology of maternal near-miss cases in AL-Najaf province, employing the criteria set forth by the World Health Organization (WHO). The study was conducted at a statistical unit within the maternal and paediatric department of AL-Zahraa Hospital in AL-Najaf. The study was conducted in the province from 2 January to 30 June 2018. The target population comprised all women admitted to the hospital during the antenatal, perinatal, and puerperium periods in September 2017.A total of 1,560 patient records were reviewed in this study according to the WHO criteria for maternal near miss, which were divided into two main groups: those with and without maternal near miss. During the study period, a total of 1,560 patients' A review of the records according to the WHO criteria for MNM revealed that 358 (22.9%) women met at least one criterion, resulting in an MNMR of 14.7 per 1000 live births. The maternal near-miss ratio is 14.7 per 1,000 live births.The likelihood of a maternal near miss increased significantly with advancing age, multiparity, non-employment status, and lack of adequate antenatal care.Preeclampsia was the most common cause, accounting for 122/358 (34.1%) of cases, followed by postpartum haemorrhage in 92 (25.7%) women, sepsis or systemic infection in 55 (15.4%), and severe anaemia in 42 (11.7%). Severe complications of abortion were identified in 36 cases (10.1%).The proportion of near-miss cases was 76.2% in hypertensive women and 16% in non-hypertensive women. Furthermore, 52.9% of women with a surgical history and 9.7% of those without a surgical history were classified as near-miss cases, respectively