Outcome of Near Miss Cases in a Periurban Hospital

A near miss or severe acute maternal morbidity (samm) means a woman (in pregnancy /labour/puerperium) who was almost dead but survived. it is often poor, socially excluded women that suffer most. the objective of this study was to explore the outcome of near miss cases admitted in the hospital along with their presentation, socio demographic characteristic and medical and surgical intervention needed. it was a cross sectional study conducted from 1st july 2009 to 31st december 2009 at institute of child and mother health. among cases who got admitted in the hospital in moribund condition with pregnancy related complications. total 91 patients were enrolled consecutively. data were collected by structured questionnaires. analysis was done using spss program. about 72% of women were at second decade of their lives and 71% of them were from poor socioeconomic condition. about 39% patients did not take any antenatal checkup. eclampsia (43%) was the prime cause of samm. next were postpartum haemorrhage (17%), obstructed labour (11%), antepartum haemorrhage (6%), ectopic pregnancy (6%), chorioamnionitis (4%), severe preeclampsia (4%), septic abortion (2%), ruptured uterus (2%), uterine perforation (1%), shock (2%), puerperal sepsis (1%), and severe anaemia (1%). along with medical care, surgical intervention such as lucs, d&c, salphingoophorectomy, hysterectomy were needed for the management of samm. more than 4 bags of blood transfusion needed in 24.50% of patients. only 4% patients needed icu admission. most of the causes of samm were apparently preventable. awareness and education about the danger signs of pregnancy, proper antenatal care, delivery by skilled birth attendant and proper auditing of care provided will be helpful to prevent samm.