A Study of Near Miss Cases in a Tertiary Care Centre as Per Laqshya Guidelines

Introduction: Maternal health is an indispensable part of a country's health care system. Over the last decade, the identication of cases of maternal morbidity has emerged as an adjunct to the investigation of maternal deaths. Maternal Near Miss (MNM) has been dened as "a woman who survives life threatening conditions during pregnancy, abortion, and childbirth or within 42 days of pregnancy termination, irrespective of receiving emergency medical/surgical Interventions". Materials and Methods: It was a hospital based observational study conducted from June 2020 to May 2021 in the Department of Obstetrics and Gynaecology at Rajindra Hospital, Patiala. Majority of the studies conducted on MNM in India are based on guidelines given by WHO. MNM cases in our study were selected on the criteria based on the MNM-Review Operational guidelines issued by ministry of health and family welfare in 2014. The common causes of MNM events were analyzed. Various indices such as the incidence of MNM in our hospital, MNM-MR, MI, SMOR were calculated and the fetal outcome in patients classied as MNM was studied. Results: There were 3171 live births, 206 near miss cases and 78 maternal deaths during the study period. The most common direct cause of maternal near miss in our study was haemorrhage (47.1%) which was followed by sepsis(23.8%), infections(9.7%),anaemia(9.3%) and hypertensive disorders(5.8%).MNM-MR in our study was 2.64:1, MNM-IR was 64.96 per 1000 live births, MI was 27.46% while SMOR was 89.56. Conclusion: Near miss mortality indicator is helpful in identifying life-threatening conditions and thus aim to prevent maternal mortality. Identication of preventable factors and preventive actions can be taken for management of complications in future near-miss cases.