Etiological profile and clinical spectrum of maternal near-miss cases in a tertiary care hospital

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Background: Maternal near-miss morbidity is an important indicator of the quality of obstetric care and reflects severe life?threatening complications occurring during pregnancy, childbirth, or the postpartum period. Analysis of maternal near?miss events provides valuable insights into preventable causes and healthcare deficiencies. Aim: To evaluate the causes, clinical profile, and outcomes of maternal near?miss morbidity in a tertiary care centre. Materials and Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology of a tertiary care hospital over a period of 24 months. A total of 62 women fulfilling the World Health Organization (WHO) maternal near?miss criteria were included using consecutive sampling. Demographic details, obstetric characteristics, etiological factors, interventions, and maternal outcomes were recorded using a structured proforma. Data were analyzed using SPSS software and expressed as frequency and percentage. Results: Most maternal near?miss cases belonged to the 21?25 years age group (38.7%) and were predominantly from rural areas (66.1%). Unbooked pregnancies accounted for 58.1% of cases. The leading causes of maternal near?miss morbidity were postpartum hemorrhage (32.3%), severe preeclampsia/eclampsia (25.8%), and sepsis (14.5%). Intensive care unit admission was required in 74.2% of patients, while 50% required massive blood transfusion. Mechanical ventilation was necessary in 29% of cases. The majority of women (91.9%) recovered and were discharged after appropriate management, whereas maternal mortality occurred in 3.2% of cases.Conclusion: Postpartum hemorrhage and hypertensive disorders remain the leading contributors to maternal near?miss morbidity. Early identification of high?risk pregnancies, timely referral, adequate antenatal care, and availability of emergency obstetric services are essential to reduce severe maternal morbidity and improve maternal outcomes.

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