BACKGROUND: Maternal mortality is an important indicator to assess the quality of services provided by the health care system. However, maternal near-misses as well as maternal mortality are also indicators of how well the health care system serves pregnant women. To improve our healthcare system in terms of investigative capacity, infrastructure, and personnel, a near-miss registry can provide important information on gaps in pregnancy facilities. This will help us to identify the requirements for referral facility improvements and the need for various health awareness programs. We, therefore, designed this study to analyze the various near-miss events in mothers and compare them with maternal mortality.
METHODS: Present study was conducted in the Department of Obstetrics and Gynecology, Lala Lajpat Rai Memorial (L.L.R.M.) Medical College associated with Sardar Vallabh Bhai Patel (S.V.B.P.) Hospital Meerut, Uttar Pradesh (UP), India for a period of one year and data were collected retrospectively from January 2022 to January 2023. All patients with life-threatening conditions such as excessive bleeding during pregnancy, hypertensive disorders of pregnancy (HDP), and septicemia that occurred during pregnancy or childbirth or within 42 days of termination of pregnancy and required ICU admissions, were included in the study. The total number of deliveries during the study period was 4,360 with 4,333 live births (LB). The total number of eligible cases was 79, out of which 52 were identified as maternal near misses and 27 were maternal mortality. Various maternal mortality and near-miss indices were analysed and statistical analysis was done using the SPSS version 21 (IBM Corp., Armonk, NY, USA).
RESULTS: Our hospital\'s maternal mortality ratio (MMR) was 623/1lakh (0.623%), which is higher than the probability due to the deficiency of appropriate medical services in the nearby areas of western UP. The number of maternal near misses per 1000 LB (maternal near-miss ratio [MNMR]) was 12/1000 LB and the severe maternal outcome rate (SMOR) was 18/1000 LB (1.82%). In our study, hemorrhage and hypertensive disorder in pregnancy were the leading cause of morbidity and mortality followed by sepsis and severe anemia. Among organ dysfunction cardiac illness followed by respiratory dysfunction was the leading cause of morbidity and mortality.
CONCLUSIONS: It is clear that there is a high burden of maternal near-miss in developing countries. There should be the establishment of well-equipped referral units at the periphery with trained manpower. The establishment of obstetrical high-dependence units (HDUs), rapid availability of blood and blood products, training of staff, and availability of multidisciplinary teams can minimize maternal mortality and morbidity.

UNASSIGNED: The major causes of maternal near miss (MNM) and maternal death (MD) are similar, so review of MNM cases is likely to yield valuable information regarding severe morbidity, which, if untreated may lead to maternal mortality.
UNASSIGNED: The objective is to determine frequency of near miss cases and identify the risk factors associated with MNM.
UNASSIGNED: A cross-sectional study was done from June 2015 to October 2017 in three hospitals in Manipur and Nagaland. All cases of MNM, which occurred during this period, were included and were reviewed using their records. Family members and health care providers of 9 recent cases were interviewed. Data collected were coded and relevant themes were identified.
UNASSIGNED: There were 32,110 deliveries, 147 near miss cases and 12 MDs, resulting in maternal mortality ratio of 38/100,000 live birth (LB), severe maternal outcome ratio of 5/1000 LB and MNM ratio of 4.6/1000 LB. MNM to mortality ratio was 12.2:1 and mortality index was 7.5%. 83% of the cases of MNM were pregnancy related while 15.6% were related to preexisting disorders. The three delays remain the decisive factors in maternal mortality.
UNASSIGNED: Most of the near miss cases experienced delay in decision to seek health care, which resulted from underestimating the severity of various pregnancy-related conditions. Poor knowledge of the risk of warning signs of pregnancy plays a major part in the delay of management.