near miss events in obstetrics

BACKGROUND: A maternal near-miss is a situation in which a woman was on the verge of death but survived a life-threatening obstetric complication that happened during pregnancy, childbirth, or within 42 days after the pregnancy's termination. Survivors of near-miss events share several features with mothers who have died and identifying determinants of maternal near miss will aid in improving the capacity of the health system to reduce severe maternal morbidity and mortality. Therefore, this study was designed to identify determinants of maternal near miss incidents among women hospitalized to tertiary hospitals in Mogadishu, Somalia...

Objective: To find out the incidence of neonatal near miss (NNM) cases in comparison with the neonatal deaths and to study the different antenatal and intrapartum maternal variables and system-related delays influencing these events. Methodology: This is a descriptive retrospective study conducted over a year (2018-2019) at a tertiary referral hospital in India, where NNM cases were selected as per 'pragmatic criteria', and detailed maternal and neonatal biological variables and near miss indicators were procured from the medical record books and analysed...

Objectives: Although neonatal near miss is an emerging concept and a tool for improving neonatal care, its magnitude and associated factors are less researched in Ethiopia. Thus, this study was aimed to uncover the magnitude of neonatal near miss and its associated factors in public hospitals in Eastern Ethiopia. Methods: A facility-based cross-sectional study was employed on a randomly selected 405 mother-neonate pairs. An interview using a structured questionnaire accompanied by review of medical records was used to collect data from the mothers and records of the neonates...

OBJECTIVE: To explore nurses' descriptions of maternal mortality when caring for women in the perinatal period in Indiana. DESIGN: A qualitative descriptive approach was used to produce nurses' descriptions of maternal mortality. SETTING/PARTICIPANTS: Convenience sample of 16 nurses recruited from the Indiana Section of the Association of Women's Health, Obstetric and Neonatal Nurses. MEASUREMENTS: Semistructured phone interviews were conducted, and participants were asked to explain their experiences related to maternal mortality...

BACKGROUND: Obstetric infections are the third most common cause of maternal mortality, with the largest burden in low and middle-income countries (LMICs). We analyzed causes of infection-related maternal deaths and near-miss identified contributing factors and generated suggested actions for quality of care improvement. METHOD: An international, virtual confidential enquiry was conducted for maternal deaths and near-miss cases that occurred in 15 health facilities in 11 LMICs reporting at least one death within the GLOSS study...

The processes of diagnosis and management involve clinical decision-making. However, decision-making is often affected by cognitive biases that can lead to medical errors. This statement presents a framework of clinical thinking and decision-making and shows how these processes can be bias-prone. We review examples of cognitive bias in obstetrics and introduce debiasing tools and strategies. When an adverse event or near miss is reviewed, the concept of a cognitive autopsy-a root cause analysis of medical decision-making and the potential influence of cognitive biases-is promoted as part of the review process...

BACKGROUND: Severe maternal morbidity or maternal near miss (MNM) events can have significant consequences for individuals, their families and society and the study of these events may inform practices to reduce future adverse pregnancy outcomes. AIMS: To review the scope of MNM studies undertaken in Australia, New Zealand, South-East Asia and the South Pacific region. MATERIALS AND METHODS: A systematic search of four online databases (MEDLINE, EMBASE, SCOPUS and CINAHL) and the World Health Organization Library was conducted to identify all relevant studies published between 1 January 2011 and 31 December 2020...

OBJECTIVE: To describe the incidence and main causes of maternal near-miss events in middle-income countries using the World Health Organization's (WHO) maternal near-miss tool and to evaluate its applicability in these settings. METHODS: We did a systematic review of studies on maternal near misses in middle-income countries published over 2009-2020. We extracted data on number of live births, number of maternal near misses, major causes of maternal near miss and most frequent organ dysfunction...

BACKGROUND: Maternal Near Miss cases have similarities with those dying from such complications and so present an important opportunity to improve practice. This study was conducted to assess the prevalence of Maternal Near Miss events and identify the delays experienced. METHODS: This was a facility-based cross-sectional study conducted in three tertiary referral hospitals from three provinces of Nepal. All the women surviving a near miss event during six months data collection period were included in the study...

Background: Monitoring rates of severe maternal morbidity (such as eclampsia and uterine rupture) is useful to assess the quality of obstetric care, particularly in low and lower-middle-income countries (LMICs). Methods: We undertook a systematic review characterising the proportion and causes of severe maternal morbidity in the Asia Pacific region. We searched Medline, Embase, Cochrane CENTRAL library and the World Health Organization Western Pacific Index database for studies in the Asia-Pacific reporting maternal morbidity/near miss using a predefined search strategy...

Aim: Obstetric patients presenting to the intensive care units (ICU) with or without underlying medical or surgical comorbidities can be a challenge to both the treating obstetrician and the intensivist. They occasionally present with near-miss events which if left untreated, can result in death. Objectives: To study the prevalence, indications of ICU admissions, near-miss events, and their effect on mortality in obstetric and puerperal patients . Material & methods: We conducted a retrospective analysis of the health records of all the obstetric and puerperal patients (pregnant and until 6 weeks postpartum) admitted to our tertiary care hospital from January 2019 to December 2020...

Background Extreme maternal morbidity is defined as "events that potentially threaten the life of a pregnant woman during pregnancy, childbirth or the puerperium, but that due to a medical intervention the patient does not die", and this is an indicator of health quality at the hospital and demographic level. Objective The aim of this study was to determine the prevalence of extreme maternal morbidity in the Women´s Hospital of Aguascalientes, Mexico. Material and methods A retrospective cross-sectional study was conducted under the criteria of the World Health Organization and the Latin American Federation of Obstetrics and Gynecology Societies for the definition of extreme maternal morbidity to determine the prevalence of near miss morbidity, between January 1 and December 31, 2016...

Maternal near-miss (MNM) is a maternal quality care indicator. The World Health Organization (WHO) defines it as a state in which a woman nearly dies but survives due to a complication during pregnancy, birth, or puerperium. The Latin American Federation of Obstetrics and Gynecology (FLASOG) and the Colombian National Health Institute (INS) established recommendations for the event's epidemiological surveillance; nonetheless, the operational definitions of the cases are different. This retrospective study examined the approaches of FLASOG and INS versus the WHO approach (gold standard) for the assessment of MNM in a high obstetric risk unit...

OBJECTIVE: To compare rates of wrong-patient orders among patients on obstetric units compared with reproductive-aged women admitted to medical-surgical units. METHODS: This was an observational study conducted in a large health system in New York between January 1, 2016, and December 31, 2018. The primary outcome was near-miss wrong-patient orders identified using the National Quality Forum-endorsed Wrong-Patient Retract-and-Reorder measure. All electronic orders placed for eligible patients during the study period were extracted retrospectively from the health system data warehouse, and the unit of analysis was the order session (consecutive orders placed by a single clinician for a patient within 60 minutes)...

BACKGROUND: The rate of neonatal mortality has declined but lesser than the infant mortality rate and remains a major public health challenge in low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 h after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors...

BACKGROUND: A maternal near-miss (MNM) refers to when a gravely ill woman survives a complication as a result of the standard of care she receives or by chance during gestation, childbirth, or within 42 days of the termination of pregnancy. Rescuers of near-miss events share several features with mothers who have died and identifying MNM determinants will aid in improving the capacity of the health system to reduce severe maternal morbidity and mortality. Ethiopia is one of the countries in sub-Saharan Africa with high maternal mortality and morbidity, but there is little evidence on determinants of a MNM based on a WHO criteria...

Objectives: A near miss in transfusion practice is defined as a deviation from standard procedures discovered before transfusion and can lead to a transfusion error. Information on near-miss events provides pivotal data on areas of improvement to prevent actual errors in the future. Our study sought to determine the prevalence and rate of near-miss events and their associated factors amongst house officers (HO) in Hospital Universiti Sains Malaysia. Methods: The initial part of this study is a descriptive cross-sectional study involving data collection from all requests sent for group, screen, and hold (GSH) and group and cross match (GXM) tests from 2011 to 2017...

BACKGROUND: Since maternal mortality is a rare event, maternal near miss has been used as a proxy indicator for measuring maternal health. Maternal near miss (MNM) refers to a woman who nearly died but survived of complications during pregnancy, childbirth or within 42 days of termination of pregnancy. Although study of MNM in Ethiopia is becoming common, it is limited to public facilities leaving private facilities aside. The objective of this study was to assess MNM among women admitted in major private hospitals in eastern Ethiopia...

Background: Parental fatigue rates after childbirth are high and may be associated with newborn drops that cause injury. Newborn drops and near-misses are potentially underreported due to parental embarrassment, shame, fear of reprisal, or guilt. Although newborn drops are rare, the leaders of mother-baby units need to enhance transparency of risk to assure a culture of safety.Purpose: To describe components and outcomes of the What A Catch program, aimed at preventing newborn drops and addressing near-misses...

Background Monitoring severe acute maternal morbidity or maternal near-miss is currently proposed by WHO as a valuable tool to assess the quality of obstetric care and implement new strategies for improving maternal health. Aim and objective The objective of this study was to assess and analyze the incidence of maternal near-miss (MNM) and maternal death (MD) at Tata Main Hospital, Jamshedpur, a tertiary care hospital in eastern India. Material and method This study was a prospective observational study conducted at Tata Main Hospital from November 2016 to October 2019...