Abstract: Maternal mortality reviews (MMR) and severe acute maternal morbidity (SAMM) and used to assess the quality of health care services. Even though admission to the intensive care unit (ICU) depends on the severity of the maternal condition and facilities, the women with severe conditions are almost always provided ICU care. Therefore, clinical and epidemiological aspects of maternal near-miss cases in the ICU will a greater picture about women with SAMM and this data can be used in planning the service provision.
Results; This hospital based, retrospective study was done on the obstetrics patients admitted to ICU between April and October 2014. It included 3872 deliveries with a live birth of 3949 and 108 near miss criteria in the study. There were only 3 (0.07%) maternal deaths during the period. The maternal near-miss incidence ratio of 27.3 per 1000 live births (LB), MMR of 75.9 per 100,000 live birth and maternal death to near-miss ratio of 1:2.78.58.3% (n=63) of them belong to age group of 20-30 years, followed by 35.2% of age over30 years and only 7 (6.5%) were of age less than 20 years. The mean age of the near-miss patients were 27± 5.93 years. 58.3% were multigravida (n=63) followed by primigravida in 45 (41.7%) patients. 87 case (80.6%) were beyond 28 weeks or intrapartum period and 9 cases (8.3%) were in the postpartum period showing that late pregnancy and delivery is the riskiest period. Late pregnancy-related conditions (n=68, 62.96%) were most frequently associated with maternal near-miss cases. PPH (n=17), heart disease complicating pregnancy (n=16) and followed by medical diseases (n=13) were the causative factors in maternal near-miss cases. Among the hypertensive related complications eclampsia (n=20, 18.5%) and severe preeclampsia (n=14, 13%) were the most frequent conditions. We recorded the highest maternal near-miss ratio because of eclampsia (5.06/1000 live births) in this study. Conclusion: This study showed that PPH, heart diseases complicating pregnancy, eclampsia, and severe preeclampsia were the principal causative factors in maternal near-miss cases. An improvement in the quality of care to detest hypertensive disorders and pre-eclampsia through strengthening preventive health-care delivery and improvement in curative care delivery to provide the best care to prevent mortality.
Keywords: epidemiology, maternal mortality, Near miss cases, intensive care units.
Title: MATERNAL NEAR MISS CASES IN THE INTENSIVE CARE UNIT, TEACHING HOSPITAL BATTICALOA, SRI LANKA
Author: Markandu Thirukumar
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
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