Journal of Gynecology and Reproductive Health
- ISSN: 2574-2728
Inês Ferreira Jorge, Carolina Dinis Nunes Mendonça Rodrigues, Leonor Andrade Faria Aboim, Elsa Maria De Jesus Ferreira Dias Villaverde Gonçalves, Carlos Manuel Alves Mendonça VerÃÂssimo Batista
Aim: The concept of monitoring "near-miss" events or severe maternal morbidity has been implemented to gather essential insights into the quality of obstetric care. Our aim is to determine and analyze the maternal near-miss cases among women admitted to the intensive/intermediate care unit at our institution and determine the maternal near-miss to mortality ratio. Methods: This is a retrospective observational non-interventional study. An audit was made of pregnant women or women within 42 days after the termination of pregnancy that were admitted to the intensive/intermediate care unit at our institution, between January 2012 and December 2020. A near-miss case was defined according to organ dysfunctionbased criteria, which include the clinical, laboratory, and management-based criteria laid down by WHO 2009. A descriptive analysis of the results was conducted. Maternal near-miss cases were classified based on their primary underlying cause. Maternal mortality during the same period was also analyzed. Results: During the study period, there were a total of 128 women admitted to the intensive/intermediate care unit. There were a total of 68 near-misses and two maternal deaths. The near-miss to mortality ratio was 34:1. Among the underlying causes of near-miss events, obstetric hemorrhage (mostly post-partum hemorrhage) and hypertensive disorders were the leading causes. They were followed by medical/surgical/mental disease or complication, other obstetric disease or complication, coincidental conditions and pregnancy-related infection. Conclusion: Hemorrhage and hypertensive disorders were the leading causes of near-miss events. Identifying near-miss cases would improve data quality and enable comparisons across institutions and countries.