A STUDY OF INCIDENCE AND DETERMINANTS OF SEVERE MATERNAL OUTCOME IN A TERTIARY CARE HOSPITAL.

Dr Jharna Behura; Dr Suparna Bhattacharyya

Volume : IX, Issue : IV, April - 2020

A STUDY OF INCIDENCE AND DETERMINANTS OF SEVERE MATERNAL OUTCOME IN A TERTIARY CARE HOSPITAL.

Dr Jharna Behura, Dr Suparna Bhattacharyya

Abstract :

Background: Evaluation of severe maternal morbidity (SMM) and severe maternal outcome (SMO) and the quality of maternal health care using near–miss approach is popularly being used in recent years. The aim of this study was to evaluate severe maternal outcome(SMO) and its determinants using this approach. Methods: This was a retrospective study conducted from January 2018 to December 2019 at a tertiary care centre in Delhi. The study population included cases with severe life threatening complications in pregnancy (SMM), maternal near–miss cases(MNM) and all cases of maternal deaths. Near–miss cases were defined based on WHO criteria 2009. Results: There were a total of 17,368 live births, 216 SMM and 163 SMO (147 maternal near–misses (MNM) and 16 maternal deaths (MD) cases. The SMO ratio was 9.24 per 1000 live births and MNM mortality ratio, mortality index (MI) and maternal mortality ratio (MMR) were 9.18:1, 9.81, 90.7 per 100,000 live births respectively. 26.9% of cases had evidence of organ dysfunction on arrival or within 12 hours of hospitalization. The commonest underlying causes for SMO were obstetric haemorrhage (52.7%) followed by hypertensive disorders (15.95%). The mortality index was maximum for heart disease (50%) followed by septic abortion (33.3%). Conclusion: There is a huge burden of near–miss and unmet need for better reproductive health services. Lack of desired antenatal visits and delays at different levels contribute to the disease burden. Emphasis should be on early identification and referral of women for timely management.