The Outcome of Women with Severe Acute Maternal Morbidity (Near Miss) Attending Tertiary Care Hospital
Objective: Determine the outcome of women with severe acute maternal morbidity (Near miss) attending tertiary care hospital.
Methodology: It was a case series study; conducted six months duration at Department of Obstetrics and Gynecology, Abbasi Shaheed Hospital, Karachi. Each patient was identified on the basis of severity of disease e.g. Eclampsia, DIC, Severe shock, severe sepsis, a blood loss > 1000ml and those who required treatment for shock. A detail study was performed to identify the factors in the community and treatment provided within the facility. All the women with alive singleton pregnancy presenting with severe acute maternal morbidity, gestational age more > 20th week to 42nd week confirmed by earlier ultrasound scan with maternal age up to 49 years were included in the study. Brief history was taken for past history of hypertension, B. P and pulse were taken. The required investigations were carried out including LFT’S and urine D/R to assess the hepatic function and urinary protein. The women will be continuously followed for seven days and outcome was looked for by the researcher. At the time of delivery birth was measured and was defined as LBW or VLBW, still birth and postpartum hospital stay. All the data entered in the proforma.
Results: The causes of maternal near miss mortality included hepatic dysfunction 33%, Shock 46% Loss of consciousness 59% Postpartum hospital stay > 7days 26% low birth weight 59% Very low birth weight 10% Still birth 33%.
Conclusion: The causes of maternal near miss mortality are essentially the same as maternal mortality. Provision of timely emergency obstritric care can play a vital role in preventing severe morbidity and in saving precious lives. Women do seek access to care for obstritical emergencies, but because of variety of problems encounters, appropriate care is delayed. Disorganized health care with lake of prompt response to is a major factor contributing to a continued high mortality rate.
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