Risk Factors Among Maternal Near Miss Cases Presenting In Tertiary Care Hospital

Background: A growing number of studies are using maternal near miss (MNM) cases to assess the standard of obstetric care. They are useful for determining risk factors that precede maternal deaths because they show cases where women survive life-threatening situations as a result of prompt intervention or resilience. Analysis of MNM events reveals trends and predictors that are essential for forming future clinical guidelines and health policies in tertiary care hospitals, where high-risk cases are routinely managed. Objective: The objective of this study was to see the association of maternal risk factors with maternal near miss among females presenting in a tertiary care hospital. Methodology: This case control study was done after taking approval from hospital ethical committee, 220 females fulfilling the inclusion and exclusion criteria were selected in the study through Emergency of Department of Obstetrics & Gynecology, Sir Ganga Ram Hospital Lahore. Informed consent was obtained. All females were divided in two groups on the basis of presence or absence of Maternal near miss (MNM). Then females were accessed for their gravidity, obesity, chronic medical conditions (hypertension, anemia and heart problem) and prior cesarean. This was confirmed through antenatal record and if present, then females were labeled as positive risk factor (as per operational definition). Results: In our study (n=220), 80%(n=88) in cases while 74.55%(n=82) in control were between 18-30 years of age while 20%(n=22) in cases and 25.45%(n=28) in control were between 31-40 years age, Mean ± SD was calculated as 26.21±4.41 in cases and 27.25±3.75 years in control, mean gestational age was calculated as 38.3+0.99 and 38.28+1.00 weeks respectively, association of maternal risk factors with maternal near miss among females presenting in a tertiary care hospital was ruled out, gravida >5 was recorded as 27.27%(n=30) in cases and 13.64%(n=15) in control group, OR was calculated as 2.37, 55.45%(n=61) in cases and 19.09%(n=21) in control group were obese, O.R was calculated as 5.27, prior cesarean section was recorded in 43.64%(n=48) in cases and 12.73%(n=14) in control group, O.R was calculated 5.31 while chronic medical condition was calculated as 41.82%(n=46) in cases and 21.82%(n=24) in control group, O.R was calculated as 2.57. Conclusion: We concluded that Gravida>5, obesity, prior cesarean section and chronic medical conditions are significantly associated with maternal near miss among females when compared to the control cases.