Abstract
A maternal near-miss (MNM) is a woman who nearly died but survived a complication that occurred during pregnancy, childbirth, or the postnatal period. A review of MNM cases is recommended to assess the quality of maternity care and understand the causes of and factors contributing to MNM and maternal deaths.
Objective To conduct a national MNM survey to provide data on which to base recommendations for the improvement of maternity care in Oman.
Design National prospective cross-sectional study was conducted for 12 months to account for any seasonality.
Methods Existing WHO guidelines and criteria were reviewed, and a systematic review of the literature was conducted to establish criteria for the identification of MNM cases identified from 23 hospitals across all 11 governorates which conduct 90.7% of all deliveries in Oman. All cases fulfilling the MNM criteria were reviewed at hospital and regional levels. 50% of cases were reviewed by the National Maternal Mortality Review Committee and a panel of international expert.
Results A total of 25 maternal deaths and 312 MNM cases were reported over a period of 12 months giving an incidence of MNM of 4.0 per 1000 births and MNM: maternal mortality ratio of 10.3:1. The majority of MNM cases (52%) occurred during the antenatal period, 28% during the postpartum period, and 20% were intrapartum. Hypertensive disorders (44%), obstetric haemorrhage (23%), and nonobstetric complications (18%) were the most common underlying causes of MNM.
In up to 35% of cases, if there had been improvement in care this might have made a difference to the outcome. Factors related to the healthcare team providing care (e.g. failure to initially recognise the seriousness of the condition) and to the women themselves (e.g. delay in seeking care) were the most commonly identified factors associated with MNM.
Conclusion There are identified opportunity for the improvement of the quality of care in Oman. The commonest causes of MNM and associated factors are potentially preventable. Addressing these causes and factors will help reducing both the number of MNM and maternal mortality in Oman.
Objective To conduct a national MNM survey to provide data on which to base recommendations for the improvement of maternity care in Oman.
Design National prospective cross-sectional study was conducted for 12 months to account for any seasonality.
Methods Existing WHO guidelines and criteria were reviewed, and a systematic review of the literature was conducted to establish criteria for the identification of MNM cases identified from 23 hospitals across all 11 governorates which conduct 90.7% of all deliveries in Oman. All cases fulfilling the MNM criteria were reviewed at hospital and regional levels. 50% of cases were reviewed by the National Maternal Mortality Review Committee and a panel of international expert.
Results A total of 25 maternal deaths and 312 MNM cases were reported over a period of 12 months giving an incidence of MNM of 4.0 per 1000 births and MNM: maternal mortality ratio of 10.3:1. The majority of MNM cases (52%) occurred during the antenatal period, 28% during the postpartum period, and 20% were intrapartum. Hypertensive disorders (44%), obstetric haemorrhage (23%), and nonobstetric complications (18%) were the most common underlying causes of MNM.
In up to 35% of cases, if there had been improvement in care this might have made a difference to the outcome. Factors related to the healthcare team providing care (e.g. failure to initially recognise the seriousness of the condition) and to the women themselves (e.g. delay in seeking care) were the most commonly identified factors associated with MNM.
Conclusion There are identified opportunity for the improvement of the quality of care in Oman. The commonest causes of MNM and associated factors are potentially preventable. Addressing these causes and factors will help reducing both the number of MNM and maternal mortality in Oman.
| Original language | English |
|---|---|
| DOIs | |
| Publication status | Published - 12 Jun 2019 |
| Event | RCOG World Congress - London, United Kingdom Duration: 17 Jun 2019 → 19 Jun 2019 |
Conference
| Conference | RCOG World Congress |
|---|---|
| Country/Territory | United Kingdom |
| City | London |
| Period | 17/06/19 → 19/06/19 |
