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near miss events in obstetrics

R P Reena, K R Radha
Severe life-threatening situations leading to a "near-miss" event may arise unexpectedly in pregnancy. Delay in seeking help, delayed access to care, and poor quality of emergency obstetric services can lead to undesirable outcomes. Women meeting the WHO "near-miss" criteria were assessed using a cross-sectional study design. These women were interviewed to evaluate the circumstances leading to a near-miss event. Reasons for delays in getting proper care were studied using the "3 delays' model...
January 2018: Indian Journal of Public Health
Shravya Tallapureddy, Revathi Velagaleti, Himabindu Palutla, Chaitanya Venkata Satti
Obstetric near-miss or severe acute maternal morbidity is gaining interest internationally as a new indicator of the quality of obstetric care. This is a retrospective study conducted using "The WHO Near-Miss Approach" to provide insight into obstetric emergencies, near-miss cases, and maternal deaths in our hospital. The maternal near-miss ratio was 8.4/1000 live births, maternal near-miss to mortality ratio was 5.3:1. Hemorrhage was the leading cause (43.7%) of morbidity in near-miss cases while hypertensive disorders were the leading cause in maternal deaths (66...
October 2017: Indian Journal of Public Health
S Tahmina, Mary Daniel, Preetha Gunasegaran
Introduction: Emergency Peripartum Hysterectomy (EPH), although relatively infrequent in present day obstetrics, is a life-saving procedure in the event of a massive postpartum haemorrhage. Aim: To assess incidence, risk factors, indications and complications of peripartum hysterectomies at a tertiary care teaching hospital in India. Materials and Methods: A retrospective study was conducted at 650-bedded tertiary care medical teaching hospital in Southern India...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
Khalifa Elmusharaf, Elaine Byrne, Ayat AbuAgla, Amal AbdelRahim, Mary Manandhar, Egbert Sondorp, Diarmuid O'Donovan
BACKGROUND: Maternity referral systems have been under-documented, under-researched, and under-theorised. Responsive emergency referral systems and appropriate transportation are cornerstones in the continuum of care and central to the complex health system. The pathways that women follow to reach Emergency Obstetric and Neonatal Care (EmONC) once a decision has been made to seek care have received relatively little attention. The aim of this research was to identify patterns and determinants of the pathways pregnant women follow from the onset of labour or complications until they reach an appropriate health facility...
August 29, 2017: BMC Pregnancy and Childbirth
Ikechukwu Innocent Mbachu, Chukwuemeka Ezeama, Kelechi Osuagwu, Osita Samuel Umeononihu, Chibuzor Obiannika, Nkeiru Ezeama
BACKGROUND: The study evaluated the pattern of severe maternal outcome, near miss indicators and associated patient and healthcare factors at a private referral hospital in rural Nigeria. METHODS: This was a cross sectional study conducted from September 2014 to August 2015 in Madonna University Teaching Hospital Elele, Rivers State, Nigeria. Pregnant and postpartum women were recruited for the study using Nigeria near miss network proforma which was adopted from the WHO near miss proforma...
July 28, 2017: BMC Pregnancy and Childbirth
Mohd Noor Norhayati, Nik Hussain Nik Hazlina, Ab Razak Asrenee, Zaharah Sulaiman
BACKGROUND: Maternal mortality has been the main way of ascertaining the outcome of maternal and obstetric care. However, maternal morbidities occur more frequently than maternal deaths; therefore, maternal near miss was suggested as a more useful indicator for the evaluation and improvement of maternal health services. Our study aimed to explore the experiences of women with maternal near miss and their perception of the quality of care in Kelantan, Malaysia. METHODS: A qualitative phenomenological approach with in-depth interview method was conducted in two tertiary hospitals in Kelantan, Malaysia...
June 15, 2017: BMC Pregnancy and Childbirth
Ewnetu Firdawek Liyew, Alemayehu Worku Yalew, Mesganaw Fantahun Afework, Birgitta Essén
BACKGROUND: Because maternal mortality is a rare event, it is important to study maternal near-miss as a complement to evaluate and improve the quality of obstetric care. Thus, the study was conducted with the aim of assessing the incidence and causes of maternal near-miss. METHODS: A facility-based cross-sectional study was conducted in five selected public hospitals of Addis Ababa, Ethiopia from May 1, 2015 to April 30, 2016. All maternal near-miss cases admitted to the selected hospitals during the study period were prospectively recruited...
2017: PloS One
Christian M Pettker
Despite our best intentions to improve health when a patient presents for care, adverse events are ubiquitous in medical practice today. Known complications related to the course of a patient's illness or condition or to the characteristics of the treatment have been an openly stated part of taking care of patients for centuries. However, it is only in the past decade that preventable adverse events, instances of harm related to error and deviations in accepted practice have become a primary part of these conversations...
April 2017: Seminars in Perinatology
Tabassum Khan, Poonam Laul, Anish Laul, Mohammed Ramzan
OBJECTIVE: To study maternal near miss (MNM) and maternal mortality to identify rectifiable risk factors. METHODS: The present cross-sectional retrospective study included pregnant women who experienced acute life-threatening pregnancy-related adverse events at Deen Dayal Upadhyay hospital, New Delhi, India, between September 1, 2009, and August 31, 2011. Patient data were analyzed to investigate factors associated with MNM events and maternal deaths. RESULTS: There were 369 patients included, and 302 MNM events and 67 maternal deaths were recorded...
August 2017: International Journal of Gynaecology and 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...
July 2017: 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
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