Audit of maternal near misses at Queen Elizabeth central hospital, Chatinkha maternity unit
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Date
2017-07-01
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Abstract
Maternal near miss is an event in which a pregnant or recently delivered woman comes
close to maternal death but does not die, due to either timely intervention or by pure
chance.
Evaluation of maternal near misses has been noted, in more developed countries, to aid
in assessing the quality of obstetric care in a maternity unit and to formulate strategies
to reduce the number of maternal deaths. It has been noted that up to 9 million women
suffer from severe obstetric complications every year.
This audit was done to determine the frequency of maternal near misses, to determine
the proportion of near misses to maternal deaths, to assess the implementation of key
evidence based interventions in women experiencing severe maternal morbidity.
This was a prospective observational folder review where data was collected on
standardized forms, from all admissions to the Chatinkha Maternity Unit at Queen
Elizabeth Central Hospital between the months of July and December 2016.
Data was entered into Epi Info and analyzed using Microsoft Excel and Epi Info.
During this study period there were a total of 5463 deliveries in the unit, of which 5337
were live births. There were a total of 303 severe maternal complications. Using the
WHO criteria, there were a total of 80(26.4%) near miss cases whilst 216(71.3%) fit the
Haydom near misses criteria. There were 19 maternal deaths that occurred in the study
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period making a maternal mortality ratio of 356 per 100 000 live births. The leading
cause of maternal near miss was obstetric haemorrhage (33.8%) followed by
hypertensive disorders in pregnancy (32.9%), whilst pregnancy related infection
(26.3%) was the commonest cause of maternal mortality.
Maternal near misses are a common occurrence in our setting, and the main causes
mirror those that cause maternal deaths. Obstetric haemorrhage and hypertensive
disorders remains a big problem in our set up and there is need to be more diligent in
preventing and treating these conditions.