Maternal Near Miss: An Analysis of Severe Maternal Morbidity and Its Determinants in a Tertiary Care Hospital

Background and Objectives: Maternal near miss cases more often as compared to maternal deaths and have similar pathways which can provide valuable information about maternal mortality and hence these cases need to be reviewed which can indirectly play a major role in reducing maternal mortality ratio in India. This study was aimed to analyze the incidence, causes, and determinants of maternal near miss events in a tertiary care hospital. Material and Methods: A retrospective analysis of health records of maternal near miss cases admitted to department of obst & gyne in tertiary care hospital from May 2024 to October 2024 was done. Patient characteristics like age, parity, gestational age, risk factors, mode of delivery, lifesaving intervention were studied. Results: Total 2784 cases were admitted in obstetrics department for deliveries, out of them 284 maternal near miss cases from which 48 were maternal mortality The maternal near miss incidence ratio was 10.20/1000 live birth and maternal near miss to mortality ratio 5.92:1. Hypertension and PPH with severe anemia was the major cause of MNM. Women with multiparity, lack of awareness are at increased risk of near miss cases. Conclusion: Hypertensive disorders in pregnancy and obstetric hemorrhage are leading cause for pregnancy specific obstetric disorder and anemia was found to be a leading cause for pre-existing condition aggravated during pregnancy. Improving timely access to quality antenatal care among pregnant mothers with quality critical care management can reduce maternal near miss cases.