Developing an assessment tool for maternal morbidity 'near-miss': a prospective study in a large Australian regional hospital

Jayaratnam, Skandarupan, De Costa, Caroline, and Howat, Paul (2011) Developing an assessment tool for maternal morbidity 'near-miss': a prospective study in a large Australian regional hospital. Australian and New Zealand Journal of Obstetrics and Gynaecology, 51 (5). pp. 421-425.

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Background: Maternal mortality is now a rare event in the developed world and its measurement is no longer a useful way of assessing obstetric care. Examination of cases of women who nearly died but survived a severe complication of pregnancy or childbirth – maternal 'near-misses' - is increasingly being recognised as potentially more useful, although severe maternal morbidity is much less easy to define and quantify than maternal death.

Aim: To identify and assess prospectively cases of severe maternal morbidity presenting to Cairns Base Hospital (CBH), to define cases as near-misses and thereby develop a tool for future assessment of obstetric care in CBH and elsewhere.

Methods: Based on approaches recommended by the recent WHO working group on Maternal Mortality and Morbidity classifications, a data collection form was constructed using a combination of named morbidities and specific interventions. Over 1 year data from all cases of severe maternal morbidity was collected and analysed both prospectively and retrospectively to identify true near-misses.

Results: Seventeen cases of true near-misses were identified, giving a near-miss rate of six per 1000 live births for CBH in the study period; 64% of cases were attributable to obstetric causes and 36% to non-obstetric causes.

Conclusions: Collection of near-miss data has the potential to become a useful tool for the assessment of obstetric care in both in CBH and in other Australian hospitals but is time-consuming and requires continuous surveillance by medical staff if cases are not to be overlooked.

Item ID: 19159
Item Type: Article (Research - C1)
ISSN: 1479-828X
Keywords: maternal, near-misses, severe morbidity
Date Deposited: 23 Nov 2011 06:37
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1114 Paediatrics and Reproductive Medicine > 111402 Obstetrics and Gynaecology @ 100%
SEO Codes: 92 HEALTH > 9299 Other Health > 929999 Health not elsewhere classified @ 100%
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