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near miss events in obstetrics

Soheila Mohammadi, Soraya Saleh Gargari, Masoumeh Fallahian, Carina Källestål, Shirin Ziaei, Birgitta Essén
BACKGROUND: Women from low-income settings have higher risk of maternal near miss (MNM) and suboptimal care than natives in high-income countries. Iran is the second largest host country for Afghan refugees in the world. Our aim was to investigate whether care quality for MNM differed between Iranians and Afghans and identify potential preventable attributes of MNM. METHODS: An MNM audit study was conducted from 2012 to 2014 at three university hospitals in Tehran...
February 13, 2017: BMC Pregnancy and Childbirth
Lavi Oud
BACKGROUND: ICU admission is uncommon among obstetric patients. Nevertheless, the epidemiology of ICU utilization is considered to be a useful proxy for study of severe maternal morbidity and near-miss events. However, there is paucity of population-level studies in obstetric patients in the United States. METHODS: The Texas Inpatient Public Use Data File and state-based reports were used to identify pregnancy-associated hospitalizations and those involving admission to ICU (n = 158,410) for the years 2001 - 2010...
February 2017: Journal of Clinical Medicine Research
Niyati T Parmar, Ajay G Parmar, Vihang S Mazumdar
BACKGROUND: Constant decline in maternal mortality ratio has given rise to the need of a new indicator. This search has motivated investigation of severe maternal morbidity-"maternal near-miss" (MNM) event. World Health Organization (WHO) defines MNM as "a woman who, being close to death, survives a complication that occurred during pregnancy, delivery or up to 42 days after the end of her pregnancy". METHODOLOGY: A hospital-based cross-sectional study was carried out at Sir Sayajirao General Hospital (SSGH), a tertiary care referral hospital in Vadodara, Central Gujarat, from May to September 2012...
October 2016: Journal of Obstetrics and Gynaecology of India
Å Wahlberg, M Andreen Sachs, K Johannesson, G Hallberg, M Jonsson, A Skoog Svanberg, U Högberg
OBJECTIVE: To examine post-traumatic stress reactions among obstetricians and midwives, experiences of support and professional consequences after severe events in the labour ward. DESIGN: Cross-sectional online survey from January 7 to March 10, 2014. POPULATION: Members of the Swedish Society of Obstetrics and Gynaecology and the Swedish Association of Midwives. METHODS: Potentially traumatic events were defined as: the child died or was severely injured during delivery; maternal near-miss; maternal mortality; and other events such as violence or threat...
August 26, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Rachel E Rowe, Jennifer J Kurinczuk, Jennifer Hollowell, Marian Knight
BACKGROUND: Midwifery-led care during labour and birth in the UK is increasingly important given national commitments to choice of place of birth, reduction of unnecessary intervention and improving women's experience of care, and evidence on safety and benefits for 'low risk' women. Further evidence is needed on safety and potential benefits of midwifery-led care for some groups of 'higher risk' women and about uncommon adverse outcomes or 'near-miss' events. Uncommon obstetric events and conditions have been investigated since 2005 using the UK Obstetric Surveillance System...
April 14, 2016: BMC Pregnancy and Childbirth
Anuradha Murki, Sheetal Dhope, Vasundhara Kamineni
AIM: To evaluate and compare the feto-maternal outcomes of pregnant women with potentially life-threatening complications (PLTC) and near miss events admitted to the obstetric high dependency units (OHDU). METHODS: Pregnant women with PLTC admitted to the OHDU were enrolled. Feto-maternal outcomes, need for NICU admission and neonatal mortality, were compared between women without near miss events (controls) and those with near miss events. RESULTS: Of the 1505 admissions to the obstetric department during the study period, 1127 delivered at our hospital...
March 2017: Journal of Maternal-fetal & Neonatal Medicine
Mohd Noor Norhayati, Nik Hussain Nik Hazlina, Zaharah Sulaiman, Mohd Yacob Azman
BACKGROUND: Severe maternal conditions have increasingly been used as alternative measurements of the quality of maternal care and as alternative strategies to reduce maternal mortality. We aimed to study severe maternal morbidity and maternal near miss among women in two tertiary hospitals in Kota Bharu, Kelantan, Malaysia. METHODS: A cross-sectional study with record review was conducted in 2014. Severe maternal morbidity and maternal near miss were classified using the new World Health Organization criteria...
March 5, 2016: BMC Public Health
Ann-Marie Howell, Elaine M Burns, George Bouras, Liam J Donaldson, Thanos Athanasiou, Ara Darzi
BACKGROUND: The National Reporting and Learning System (NRLS) collects reports about patient safety incidents in England. Government regulators use NRLS data to assess the safety of hospitals. This study aims to examine whether annual hospital incident reporting rates can be used as a surrogate indicator of individual hospital safety. Secondly assesses which hospital characteristics are correlated with high incident reporting rates and whether a high reporting hospital is safer than those lower reporting hospitals...
2015: PloS One
Sadic Kagwa, Mark A Hoeft, Paul G Firth, Stephen Ttendo, Vicki E Modest
BACKGROUND: Transversus abdominis plane (TAP) block provides 12-24 h of analgesia to the parietal peritoneum and abdominal wall, and are best used combined with oral or intravenous medications. Despite ease of use, a large margin of safety, and a high success rate, TAP blocks remain under used in settings where patients could most benefit from their use. Previous studies have used oral or intravenous narcotics for supplementation. However, the efficacy of TAP blocks in low-resourced settings where patients do not have dependable access to these medications is unknown...
April 27, 2015: Lancet
Bouchra Assarag, Bruno Dujardin, Amina Essolbi, Imad Cherkaoui, Vincent De Brouwere
OBJECTIVE: In Morocco, medical care for women with severe obstetric complications (near-miss cases) ends at discharge from the hospital. Little information exists regarding what happens after returning home. The aim of the study was to assess the physical and mental health consequences of near-miss events on Moroccan women 8 months after childbirth. METHODS: A prospective cohort study of 76 near-miss women was conducted in three hospitals. For every case, we recruited at least two women from the same hospital who had uncomplicated deliveries (n=169)...
August 13, 2015: Tropical Medicine & International Health: TM & IH
O T Oladapo, O O Adetoro, B A Ekele, C Chama, S J Etuk, A P Aboyeji, H E Onah, A M Abasiattai, A N Adamu, O Adegbola, A S Adeniran, C O Aimakhu, O Akinsanya, L D Aliyu, A B Ande, A Ashimi, M Bwala, A Fabamwo, A D Geidam, J I Ikechebelu, J O Imaralu, O Kuti, D Nwachukwu, L Omo-Aghoja, K Tunau, J Tukur, Ouj Umeora, A C Umezulike, O A Dada, Ӧ Tunçalp, J P Vogel, A M Gülmezoglu
OBJECTIVE: To investigate the burden and causes of life-threatening maternal complications and the quality of emergency obstetric care in Nigerian public tertiary hospitals. DESIGN: Nationwide cross-sectional study. SETTING: Forty-two tertiary hospitals. POPULATION: Women admitted for pregnancy, childbirth and puerperal complications. METHODS: All cases of severe maternal outcome (SMO: maternal near-miss or maternal death) were prospectively identified using the WHO criteria over a 1-year period...
May 2016: BJOG: An International Journal of Obstetrics and Gynaecology
Diana J Behling, Michelle Renaud
Maternal morbidity and mortality is a national health problem. Causal analysis of near-miss and actual serious patient safety events, including those resulting in maternal death, within obstetric units often highlights a failure to promptly recognize and treat women who were exhibiting signs of decompensation/deterioration. The Obstetric Vital Sign Alert (OBVSA) is an early warning tool that leverages discrete data points in the electronic health record, calculating a risk score that is displayed as a visual cue for acute care obstetric staff...
April 2015: Nursing for Women's Health
Scovia N Mbalinda, Annettee Nakimuli, Sarah Nakubulwa, Othman Kakaire, Michael O Osinde, Nelson Kakande, Dan K Kaye
BACKGROUND: Severe obstetric complications have potential negative impact on the family and household of the survivors, with potential negative effects during (and in the aftermath of) the traumatic obstetric events. The objective was to gain deeper understanding of how severe obstetric complications are perceived by male partners, and their impact on the livelihoods of the family and community. METHODS: Data was collected through 25 in-depth narrative interviews with male partners of women with severe obstetric morbidity...
March 24, 2015: Reproductive Health
Ernestina David, Fernanda Machungo, Giovanni Zanconato, Elena Cavaliere, Sidonia Fiosse, Celeste Sululu, Benvinda Chiluvane, Staffan Bergström
BACKGROUND: Life-threatening events during pregnancy are currently used as a measure to assess quality of obstetric care. The aim of this study is to assess prevalence of near miss cases and maternal deaths, to elucidate the causes and to analyze avoidable factors based upon the three-delays approach in southern Mozambique. METHODS: Near miss cases comprised five categories: eclampsia, severe hemorrhage, severe sepsis, uterine rupture and severe malaria. Pregnant women surviving the event were interviewed during a 5-month period within five health facilities offering comprehensive emergency obstetric care in Maputo City and Province...
2014: BMC Pregnancy and Childbirth
Sanghita Bhattacharyya, Aradhana Srivastava, Marian Knight
BACKGROUND: In India there is a thrust towards promoting institutional delivery, resulting in problems of overcrowding and compromise to quality of care. Review of near-miss obstetric events has been suggested to be useful to investigate health system functioning, complementing maternal death reviews. The aim of this project was to identify the key elements required for a near-miss review programme for India. METHODS: A structured review was conducted to identify methods used in assessing near-miss cases...
November 13, 2014: BMC Health Services Research
Dan K Kaye, Othman Kakaire, Annettee Nakimuli, Scovia N Mbalinda, Michael O Osinde, Nelson Kakande
OBJECTIVE: To gain an understanding of how obstetric complications affect the lives and livelihoods of survivors. METHODS: A phenomenological study was conducted between April and August 2013 at Mulago Hospital, Kampala, Uganda. Data were collected through in-depth interviews among 36 women admitted with obstetric near miss. The interviews investigated perceptions, lived experiences, and meanings attached to such experiences by survivors. More specifically, the questions explored: self-rated health; anticipated social, sexual, and reproductive health challenges; and mitigating factors...
December 2014: International Journal of Gynaecology and Obstetrics
Patrícia Santos Resende Cardoso, Regina Amélia Lopes Pessoa de Aguiar, Marcos Borato Viana
OBJECTIVE: To evaluate complications in pregnant women with sickle cell disease, especially those leading to maternal death or near miss (severe obstetric complications). METHODS: A prospective cohort of 104 pregnant women registered in the Blood Center of Belo Horizonte (Hemominas Foundation) was followed up at high-risk prenatal units. They belonged to Group I (51 hemoglobin SS and three hemoglobin S/β(0)-thalassemia) or Group II (49 hemoglobin SC and one hemoglobin S/β(+)-thalassemia)...
July 2014: Revista Brasileira de Hematologia e Hemoterapia
Juliana C Giordano, Mary A Parpinelli, Jose G Cecatti, Samira M Haddad, Maria L Costa, Fernanda G Surita, Joao L Pinto E Silva, Maria H Sousa
OBJECTIVE: Maternal mortality (MM) is a core indicator of disparities in women's rights. The study of Near Miss cases is strategic to identifying the breakdowns in obstetrical care. In absolute numbers, both MM and occurrence of eclampsia are rare events. We aim to assess the obstetric care indicators and main predictors for severe maternal outcome from eclampsia (SMO: maternal death plus maternal near miss). METHODS: Secondary analysis of a multicenter, cross-sectional study, including 27 centers from all geographic regions of Brazil, from 2009 to 2010...
2014: PloS One
Lisa Hinton, Louise Locock, Marian Knight
OBJECTIVE: Severe life-threatening complications in pregnancy that require urgent medical intervention are commonly known as "near-miss" events. Although these complications are rare (1 in 100 births), there are potentially 8,000 women and their families in the UK each year who live through a life-threatening emergency and its aftermath. Near-miss obstetric emergencies can be traumatic and frightening for women, and their impact can last for years. There is little research that has explored how these events impact on partners...
2014: PloS One
Ashma Rana, Gehanath Baral, Ganesh Dangal
INTRODUCTION: Multicenter surveillance has been carried out on maternal near-miss in the hospitals with sentinel units. Near-miss is recognized as the predictor of level of care and maternal death. Reducing Maternal Mortality Ratio is one of the challenges to achieve Millennium Development Goal. The objective was to determine the frequency and the nature of near-miss events and to analyze the near-miss morbidities among pregnant women. METHODS: A prospective surveillance was done for a year in 2012 at nine hospitals in Kathmandu valley...
April 2013: JNMA; Journal of the Nepal Medical Association
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