Factors Associated with Maternal Near-miss Among Women Admitted in A Rural Hospital: A Single-Center Study

Background: Maternal Near-miss (MNM) is one of the related concepts to maternal mortality. MNM is a special category of survivors, whose stories provide unique insights and valuable information on maternal mortality. Characterizing near-miss morbidity is valuable for monitoring the quality of hospital-based obstetric care and should be calculated regularly for planning, monitoring, and evaluating provided maternal healthcare. Objectives: The study aimed to observe the factors like patterns and predictors related to maternal near-miss in our demographic.Material & Methods:This cross-sectional observational study was conducted at the Department of Obstetrics and gynaecology, Sirajgonj Medical College and Hospital, Sirajgonj, Bangladesh. The study duration was 1 year, from June 2019 to May 2020. During the study period, a total of 1277 deliveries were conducted at the study hospital, among which, 69 cases were of MNM. Results:The rate of maternal near-miss in our study was 5.41% of the total admitted maternal pregnancy cases. The maternal near-miss mortality ratio (MNM: 1 MD) was 1:13.8. Out of the 69 near-miss cases, 82.6% of women met the MNM criteria already at admission, and another 17.4% of near-miss cases were distributed: 10.1% developed near-miss after admission within the first 12 hours of the hospital admission, whereas the occurrence of MNM after 12 hours of the hospital admission was observed in 7.3% of cases. Conclusions:MNM cases are alarmingly high. Hypertensive disorders of pregnancy and obstetric hemorrhage were the two main direct obstetric causes of near-misses that require strict and quick management protocols. A proper antenatal check-up to discourage early marriage and pregnancy and timely referral to well-equipped health facilities with logistic support is necessary for saving human life.