School of Medicine & Oral Health

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Browsing School of Medicine & Oral Health by Author "Mvula, Priscilla Precious Mwenecho"

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    Audit of maternal near misses at Queen Elizabeth central hospital, Chatinkha maternity unit
    (2017-07-01) Mvula, Priscilla Precious Mwenecho
    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 vii 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.