# Maternal Near Miss Morbidity and Mortality: An Audit Analysis of 10 Years From a Private Tertiary Care Obstetric Center

## TL;DR

This study analyzed 10 years of maternal health data to identify the main causes of severe complications and deaths in women at a private hospital in India.

## Contribution

The study provides a detailed audit of maternal near-miss and mortality cases over a decade, identifying key risk factors and outcomes.

## Key findings

- Hemorrhage and preeclampsia were the most common causes of maternal near-miss cases.
- Hypertensive disorders were the leading cause of maternal deaths.
- The study found low rates of maternal mortality compared to morbidity.

## Abstract

Background

Maternal near-miss morbidity (MNM) and maternal death (MD) are indicators of the quality of maternal health care. Despite various efforts, MNM and MD rates remain high in several nations. Therefore, it is important to develop new strategies to address this issue.

Objectives

The primary objective of this study was to determine the proportion of potentially life-threatening conditions (PLTC), life-threatening conditions (LTC), MNM cases, and MD cases among all women booked for care at the study site over the last 10 years. The secondary objectives of the study were to calculate the maternal morbidity and mortality indices and elucidate the underlying profile of MNM and MD cases.

Materials and methods

A clinical audit of data from Fernandez Hospital, Hyderabad, India, from January 2011 to December 2020 was carried out. Data of women diagnosed with PLTC during the study period were extracted. Incidences of MNM and MD were calculated along with other mortality and morbidity indicators. Etiologies of MNM and MD were evaluated.

Results

Of the 79,069 women included in the study, PLTC, LTC, MNM, and MD were noted in 7410 (9.37%), 245 (0.31%), 233 (0.29%), and 12 (0.015%) cases, respectively. Hemorrhage and preeclampsia were seen in 88 (37.77%) and 44 (18.88%) cases, respectively. Hypertensive disorders were the most common cause of MD, as seen in five (41.7%) cases.

Conclusions

Hemorrhage and hypertension were the leading causes of MNM in our study, and hypertension was the leading cause of MD. It is crucial for maternity centers to implement strategies to identify at-risk women. Such cases should be evaluated, diagnosed, and treated as soon as possible to avoid MNM and preventable MD.