Maternal ‘near miss’ at Royal Darwin Hospital: an analysis of severe maternal morbidity at an Australian regional tertiary maternity unit

Jayaratnam, Skandarupan, Burton, Alice, Connan, Kirsten Fiona, and De Costa, Caroline (2016) Maternal ‘near miss’ at Royal Darwin Hospital: an analysis of severe maternal morbidity at an Australian regional tertiary maternity unit. Australian and New Zealand Journal of Obstetrics and Gynaecology, 56 (4). pp. 381-386.

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DOI: 10.1111/ajo.12436

View at Publisher Website: http://dx.doi.org/10.1111/ajo.12436

Abstract

Background: Assessment of severe maternal morbidity using World Health Organization (WHO) 'near-miss' criteria is gaining in importance as a valuable tool in the assessment of maternity care of women. Identification of cases allows an understanding of aetiology of severe morbidity and factors contributing to poor maternal outcomes.

Aim: The aim of this study is to determine the rate of maternal 'near miss' at Royal Darwin Hospital (RDH) and the utility of the WHO near-miss criteria as a tool for data collection in a regional Australian context.

Methods and materials: Cases of maternal 'near miss' and deaths were prospectively identified over a period of 12 months using the WHO criteria.

Results: During the audit period, there were 2080 live births at Royal Darwin Hospital (RDH): 10 women presented with a 'near miss' and there was one maternal death. The maternal mortality ratio for the hospital was 48/100 000 live births, the maternal 'near-miss' index ratio was 4.8/1000 live births, and the combination of maternal deaths and near misses gave a severe maternal outcome (SMO) ratio of 5.3/1000 live births. The main cause of obstetric 'near miss' was obstetric haemorrhage. Indigenous women and women from remote areas comprised a significant portion of 'near-miss' cases.

Conclusion: The rates of maternal 'near miss' at RDH are consistent with other studies in the developed world. The WHO maternal 'near-miss' audit tool helps health professionals understand and anticipate severe maternal morbidities, with the aim of improving maternal and perinatal outcomes.


Item ID:	48505
Item Type:	Article (Research - C1)
ISSN:	1479-828X
Keywords:	indigenous; maternal; morbidity; pregnancy
Date Deposited:	18 Apr 2017 05:27
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3215 Reproductive medicine > 321502 Obstetrics and gynaecology @ 100%
SEO Codes:	97 EXPANDING KNOWLEDGE > 970111 Expanding Knowledge in the Medical and Health Sciences @ 50% 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920114 Reproductive System and Disorders @ 50%
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