Incidence of maternal near miss in the public health sector of Harare, Zimbabwe: a prospective descriptive study
Abstract Background Maternal ‘near miss’ can be a proxy for maternal death and it describes women who nearly died due to obstetric complications. It measures life threatening pregnancy related complications and allows the assessment of the quality of obstetric care. Methods A prospective descriptive...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-11-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12884-018-2092-7 |
| _version_ | 1818283533692567552 |
|---|---|
| author | Henry Chikadaya Mugove Gerald Madziyire Stephen P. Munjanja |
| author_facet | Henry Chikadaya Mugove Gerald Madziyire Stephen P. Munjanja |
| author_sort | Henry Chikadaya |
| collection | DOAJ |
| description | Abstract Background Maternal ‘near miss’ can be a proxy for maternal death and it describes women who nearly died due to obstetric complications. It measures life threatening pregnancy related complications and allows the assessment of the quality of obstetric care. Methods A prospective descriptive study was carried out from October 1 2016 to 31 December 2016, using the WHO criteria for maternal ‘near miss’ at the two tertiary public hospitals which receive referrals of all obstetric complications in Harare city, Zimbabwe. The objective was to calculate the ratio of maternal ‘near miss’ and associated factors. All pregnant women who developed life threatening complications classified as maternal near miss using the WHO criteria were recruited and followed up for six weeks from discharge, delivery or termination of pregnancy or up to the time of death. Results During this period there were 11,871 births. One hundred and twenty three (123) women developed severe maternal outcomes, 110 were maternal ‘near miss’ morbidity and 13 were maternal deaths. The maternal ‘near miss’ ratio was 9.3 per 1000 deliveries, the mortality index (MI) was 10.6% and the maternal mortality ratio was 110 per 100,000 deliveries. The major organ dysfunction among cases with severe maternal outcomes (SMO) was cardiovascular dysfunction (76.9%). The major causes of maternal near miss were obstetric haemorrhage (31.8%), hypertensive disorders (28.2%) and complications of miscarriages (20%). The intensive care unit (ICU) admission rate was 7.3 per 100 cases of SMO and 88.8% of maternal deaths occurred without ICU admission. Conclusion The MNM ratio was comparable to that in the region. Obstetric haemorrhage was a leading cause of severe maternal morbidity though with less mortality when compared to hypertensive disorders and abortion complications. Zimbabwe should adopt maternal near miss ratio as an indicator for evaluating its maternal health services. |
| first_indexed | 2024-12-13T00:38:26Z |
| format | Article |
| id | doaj.art-2671dc8bf0094277aef4e0cdb09a4765 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-13T00:38:26Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-2671dc8bf0094277aef4e0cdb09a47652022-12-22T00:05:10ZengBMCBMC Pregnancy and Childbirth1471-23932018-11-011811610.1186/s12884-018-2092-7Incidence of maternal near miss in the public health sector of Harare, Zimbabwe: a prospective descriptive studyHenry Chikadaya0Mugove Gerald Madziyire1Stephen P. Munjanja2Department of Obstetrics and Gynaecology, University of Zimbabwe College of Health SciencesDepartment of Obstetrics and Gynaecology, University of Zimbabwe College of Health SciencesDepartment of Obstetrics and Gynaecology, University of Zimbabwe College of Health SciencesAbstract Background Maternal ‘near miss’ can be a proxy for maternal death and it describes women who nearly died due to obstetric complications. It measures life threatening pregnancy related complications and allows the assessment of the quality of obstetric care. Methods A prospective descriptive study was carried out from October 1 2016 to 31 December 2016, using the WHO criteria for maternal ‘near miss’ at the two tertiary public hospitals which receive referrals of all obstetric complications in Harare city, Zimbabwe. The objective was to calculate the ratio of maternal ‘near miss’ and associated factors. All pregnant women who developed life threatening complications classified as maternal near miss using the WHO criteria were recruited and followed up for six weeks from discharge, delivery or termination of pregnancy or up to the time of death. Results During this period there were 11,871 births. One hundred and twenty three (123) women developed severe maternal outcomes, 110 were maternal ‘near miss’ morbidity and 13 were maternal deaths. The maternal ‘near miss’ ratio was 9.3 per 1000 deliveries, the mortality index (MI) was 10.6% and the maternal mortality ratio was 110 per 100,000 deliveries. The major organ dysfunction among cases with severe maternal outcomes (SMO) was cardiovascular dysfunction (76.9%). The major causes of maternal near miss were obstetric haemorrhage (31.8%), hypertensive disorders (28.2%) and complications of miscarriages (20%). The intensive care unit (ICU) admission rate was 7.3 per 100 cases of SMO and 88.8% of maternal deaths occurred without ICU admission. Conclusion The MNM ratio was comparable to that in the region. Obstetric haemorrhage was a leading cause of severe maternal morbidity though with less mortality when compared to hypertensive disorders and abortion complications. Zimbabwe should adopt maternal near miss ratio as an indicator for evaluating its maternal health services.http://link.springer.com/article/10.1186/s12884-018-2092-7Maternal near missMaternal mortalitySevere maternal morbiditySevere maternal outcomeMortality indexs |
| spellingShingle | Henry Chikadaya Mugove Gerald Madziyire Stephen P. Munjanja Incidence of maternal near miss in the public health sector of Harare, Zimbabwe: a prospective descriptive study BMC Pregnancy and Childbirth Maternal near miss Maternal mortality Severe maternal morbidity Severe maternal outcome Mortality indexs |
| title | Incidence of maternal near miss in the public health sector of Harare, Zimbabwe: a prospective descriptive study |
| title_full | Incidence of maternal near miss in the public health sector of Harare, Zimbabwe: a prospective descriptive study |
| title_fullStr | Incidence of maternal near miss in the public health sector of Harare, Zimbabwe: a prospective descriptive study |
| title_full_unstemmed | Incidence of maternal near miss in the public health sector of Harare, Zimbabwe: a prospective descriptive study |
| title_short | Incidence of maternal near miss in the public health sector of Harare, Zimbabwe: a prospective descriptive study |
| title_sort | incidence of maternal near miss in the public health sector of harare zimbabwe a prospective descriptive study |
| topic | Maternal near miss Maternal mortality Severe maternal morbidity Severe maternal outcome Mortality indexs |
| url | http://link.springer.com/article/10.1186/s12884-018-2092-7 |
| work_keys_str_mv | AT henrychikadaya incidenceofmaternalnearmissinthepublichealthsectorofhararezimbabweaprospectivedescriptivestudy AT mugovegeraldmadziyire incidenceofmaternalnearmissinthepublichealthsectorofhararezimbabweaprospectivedescriptivestudy AT stephenpmunjanja incidenceofmaternalnearmissinthepublichealthsectorofhararezimbabweaprospectivedescriptivestudy |