Maternal near miss in low‐resource areas. Issue 3 (13th June 2017)

• Record Type: Journal Article
• Authors: Goldenberg, Robert L.; Saleem, Sarah; Ali, Sumera; Moore, Janet L.; Lokangako, Adrien; Tshefu, Antoinette; Mwenechanya, Musaku; Chomba, Elwyn; Garces, Ana; Figueroa, Lester; Goudar, Shivaprasad; Kodkany, Bhalachandra; Patel, Archana; Esamai, Fabian; Nsyonge, Paul; Harrison, Margo S.; Bauserman, Melissa; Bose, Carl L.; Krebs, Nancy F.; Hambidge, K. Michael; Derman, Richard J.; Hibberd, Patricia L.; Liechty, Edward A.; Wallace, Dennis D.; Belizan, Jose M.; Miodovnik, Menachem; Koso‐Thomas, Marion; Carlo, Waldemar A.; Jobe, Alan H.; McClure, Elizabeth M.
• Is Part Of: International journal of gynaecology and obstetrics. Volume 138:Issue 3(2017)
• Page Start: 347
• Page End: 355
• Publication Date: 2017-06-13
• Subjects: Low‐ and middle‐income countries -- Maternal mortality -- Maternal near miss; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.12219
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To describe the Global Network Near‐Miss Maternal Mortality System and its application in seven sites. Methods: In a population‐based study, pregnant women eligible for enrollment in the Maternal and Newborn Health Registry at seven sites (Democratic Republic of the Congo; Guatemala; Belagavi and Nagpur, India; Kenya; Pakistan; and Zambia) between January 2014 and April 2016 were screened to identify those likely to have a near‐miss event. The WHO maternal near‐miss criteria were modified for low‐resource settings. The ratio of near‐miss events to maternal deaths was calculated. Results: Among 122 707 women screened, 18 307 (15.0%) had a potential near‐miss event, of whom 4866 (26.6%; 4.0% of all women) had a near‐miss maternal event. The overall maternal mortality ratio was 155 per 100 000 live births. The ratio of near‐miss events to maternal deaths was 26 to 1. The most common factors involved in near‐miss cases were the hematologic/coagulation system, infection, and cardiovascular system. Conclusion: By using the Global Network Near‐Miss Maternal Mortality System, large numbers of women were screened for near‐miss events, including those delivering at home or a low‐level maternity clinic. The 4.0% incidence of near‐miss maternal mortality is similar to previously reported data. The ratio of 26 near‐miss cases to 1 maternal death suggests that near miss might evaluate the impact of interventions more efficiently than maternal mortality. Abstract : The Global Network Near‐Miss Maternal Mortality System found that 4% of pregnant women experienced a near‐miss event; there were 26 events for each maternal death.