Maternal Near Miss Among Women Admitted to Al-Manathera General Hospital/ Iraq

Abstract

Introduction: Maternal near-miss (MNM) precedes maternal mortality, both are indicators of the quality of health care services provided to pregnant women, and their cases have common characteristics, especially in terms of risk factors. The objective of the study is to identify causes and the factors associated with maternal near-miss through women admitted to Al- Manathera general hospital in the Al-Najaf governorate/ Iraq.

Materials and Methods: Descriptive cross-sectional study was conducted in the obstetric ward and labor room of Al Manathera general hospital. The data collection period lasted three months from March to June 2022. About 165 women were enrolled in this study, Fifty-five women met the WHO criteria for a near miss. A structured questionnaire was used to collect the data for women admitted to a labor room and obstetric wards. Data analyzed by using the statistical package of SPSS-25 and Pearson Chi-square test (c²-test) was used to compare the distributions of factors associated with maternal near miss. The significance level was established at p-value ≤ 0.05.

Result: During three months, the total number of deliveries was 1596 and the total live births were 1583. The total number of near miss cases was 55. Severe obstetric hemorrhage was the most common cause of maternal near-miss (65.5%) followed by severe preeclampsia (18.2%). Factors that were significantly associated with MNM (compared to Non MNM) were women education (p = 0.023), gravidity (p = 0.004), mode of delivery (p = 0.000), gestational age (p = 0.000), desire of the last pregnancy (p = 0.001), last birth outcome (p = 0.000) and history of any obstetric complications (p = 0.000).

Conclusion and Recommendations: Severe obstetric hemorrhage and severe preeclampsia were the most common causes of maternal near miss. Factors found to be associated with maternal near miss are women’s education, gravidity, mode of delivery, gestational age at delivery, desire of the last pregnancy, last birth outcome, and history of any obstetric complications. To reducing MNM in Al-Manathera general hospital should focus on women who are at risk of maternal near miss and increase access to maternal health care services by enhancing the efforts of health care providers in the delivery room.