Severe Cardiac Dysfunction in Pregnancy- A Maternal Near Miss.

ABSTRACT

Maternal near miss is defined as a pregnancy which survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy.[1] India’s MMR has significantly declined from 167 in 2011-13 to 130 in 2014-16. According to guidelines on Maternal Near Miss given by Ministry of Health and Family Welfare, December 2014, for diagnosing a patient with severe cardiac dysfunction, grade-4 (WHO classification) which is a contra -indication to pregnancy, who met single heart criteria to be defined as MNM with abnormal acid-base values, need for ventilatory support, ICU admission, digitalisation, use of cardio- tonics, inotrope support, intra-cardiac intervention OR patient should meet minimum three criteria one each from clinical findings, investigations and interventions. There are certain single heart criteria like breathlessness, orthopnoea, tachycardia, organic murmurs, abnormal ECG and abnormal 2-D ECHO which puts the patient as MNM.[3]