Maternal near-miss events in developing countries

In 2015, the United Nations adopted the Sustainable Development Goals (SDGs), including a target to reduce maternal mortality (MM) by two-thirds – by the year 2030. The rates of maternal mortality are particularly high in low-income countries, where 99% of such deaths occur. The World Health Organization (WHO) defines a Maternal Near-Miss event as a situation where a woman narrowly survives a serious complication during pregnancy, delivery, or up to 42 days postpartum. This concept has been integrated into healthcare systems, with maternal near-miss audits emerging as a valuable tool for enhancing obstetric care quality.

A recent study aimed to assess baseline data on Maternal Near-Miss (MNM) cases, analyze causes, and evaluate interventions to improve maternal health.

This descriptive study was conducted at PCMC’s Postgraduate Institute and YCM Hospital in Pimpri Pune, Maharashtra – between January 1, 2020 and June 30, 2021. This study identified Maternal Near Miss (MNM) cases based on the WHO criteria. 

Among 9,534 admissions, there were 130 severe maternal outcomes – including 114 MNM cases and 16 maternal deaths. Most MNM cases (91.23%) occurred in women aged 20-35 years––with 72.13% from rural areas and 68.42% referred from other health facilities. Of the MNM cases, 63.86% were multigravida. Meanwhile, hypertension in pregnancy was observed in 60.53% of cases, followed by hemorrhage in 54.39%.

The findings indicated that hypertension and hemorrhage are significant causes of MNM cases. They underscore the crucial role of intensive care units (ICUs) and blood banks in preventing maternal mortality and suggests that improving high-dependency unit (HDU)/ICU facilities and blood bank resources is essential for enhancing maternal health outcomes in developing countries.

Source: Thakkarwad S, Supe M, Mundlod S, et al. Indian J Obstet Gynecol Res 2024;11(3):351-357