Analysis of Maternal Near Miss Cases in a Tertiary Care Center

Introduction: Maternal near miss (MNM) cases involve severe complications during pregnancy, childbirth, or postpartum, where women survive life-threatening events due to timely medical interventions. These cases offer valuable insights into healthcare systems, revealing both successes and gaps in care, particularly in tertiary care settings that manage high-risk pregnancies. Materials and Methods: This retrospective observational study was conducted from July 2023 to July 2024 at Guru Gobind singh Government Hospital (GGH), Jamnagar. A total of 280 MNM cases were analyzed based on the World Health Organization’s (WHO) criteria, focusing on severe obstetric complications such as hemorrhage, hypertensive disorders, sepsis, and organ dysfunction. Data were collected from medical records, including patient demographics, clinical characteristics, interventions, and outcomes. Descriptive statistics were used for analysis, with significance evaluated at p < 0.05. Results: A total of 280 maternal near-miss (MNM) cases were analyzed. Multigravida women represented the largest group with 127 cases (45.36%), followed by second gravida (79 cases, 28.21%) and primigravida (74 cases, 26.42%). Hypertensive disorders, including preeclampsia and eclampsia, were the leading causes, accounting for 42.14% of cases, followed by severe anemia (18.57%) and obstetric hemorrhages such as APH (10.00%) and PPH (7.50%). Blood products were the most frequent intervention (82%), followed by uterine packing (8%) and laparotomy (4%). Most cases resulted in live births (77%), though adverse outcomes included 49 stillbirths (18%) and 15 cases (5%) involving ectopic pregnancies or abortions. Conclusion: Our study highlights that hypertensive disorders and severe anemia are major contributors to maternal near-miss cases, with timely interventions such as blood transfusions playing a critical role in positive outcomes. Despite most cases resulting in live births, the occurrence of stillbirths and other complications underscores the need for continuous improvements in maternal care.