Maternal near miss events in a tertiary care teaching hospital: a prospective analysis of risk factors, clinical outcomes and healthcare system performance

Background: Maternal health is a critical indicator of a nation's overall health and development. Maternal near miss (MNM) cases, defined as women who nearly died but survived a life-threatening complication during pregnancy or childbirth, offer valuable insights into improving maternal healthcare systems. Methods: A comprehensive analysis was conducted at a tertiary care teaching hospital to identify MNM cases using world health organization's (WHO) standardized criteria, which include clinical, laboratory, and management-based indicators. Data on the frequency, causes, and outcomes of MNM events were collected and analyzed to assess the quality of care provided. The study was a prospective design, conducted for 6 months from January 2024 to June 2024, involving 50 participants. Results: The study found that hemorrhage, hypertensive disorders, and sepsis were the most common causes of MNM. Early identification and timely intervention were crucial in preventing progression to maternal death. The study also highlighted the impact of health system factors, such as accessibility to emergency obstetric care and the availability of skilled healthcare providers, on the incidence of MNM. Blood transfusion was the most common life-saving intervention (30%), and 64% of cases were pregnancy-related. Conclusions: MNM cases occur more frequently than maternal deaths and provide a larger sample size for analysis, leading to improved maternal care and reduced maternal mortality. The findings underscore the importance of enhancing healthcare infrastructure, training healthcare providers, and implementing evidence-based interventions to improve maternal outcomes.