A BSTRACT Objective: To determine the prevalence of maternal near-miss (MNM) cases with their associated factors at a tertiary care hospital in Pune, Maharashtra, India. Methods: This retrospective observational study, conducted from October 2022 to January 2024 at a tertiary care hospital in Pune, India, included women who met WHO criteria for maternal near-miss (MNM). Data collected from labor wards and intensive care units were analyzed, computing MNM ratios, mortality indices, and comparing demographic and clinical parameters using Chi-square tests and 95% confidence intervals. Results: Of 2448 deliveries, 54 cases were maternal near misses (maternal near-miss ratio of 22.02 per 1000 live births), 2 maternal deaths (maternal mortality index: 3.5%) and near-miss to mortality ratio of 27:1. Most were women aged 30-34 years (35.19%) and multigravida (55.56%). Pearson’s Chi-square test revealed that postcesarean section, threatened abortion, molar pregnancy, retained placenta, twin gestation (all with P < 0.001), and post-IVF ET pregnancy ( P = 0.002) were significantly associated with adverse maternal outcomes. Hypertensive disorders (51.85%, 28/54) and obstetrical hemorrhages (48.14%, 26/54) were the primary causes of MNM. Blood transfusion was required for 40.74%, with 18.52% (10/54) needing large-volume transfusions; coagulation dysfunction was present in 20.8%, Intensive Care Unit admission (ICU) admission in 37.04% (20/54), 5.88% required dialysis, and 7.4% underwent cesarean hysterectomy. Conclusion: Studying MNM cases and their associated factors is crucial for optimizing obstetric care and enhancing preparedness to manage and prevent such incidents. Primigravida, advanced maternal age, hypertensive disorders of pregnancy, and women undergoing cesarean deliveries require meticulous obstetric care and diligent follow-up with ensuring the prompt availability of blood and blood products.
Mukhopadhyay et al. (Sun,) studied this question.