Maternal 'near miss' collection at an Australian tertiary maternity hospital

Jayaratnam, Skandarupan, Kua, Sonia, deCosta, Caroline, and Franklin, Richard (2018) Maternal 'near miss' collection at an Australian tertiary maternity hospital. BMC Pregnancy and Childbirth, 18. 221.

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Background: Australia has a maternal mortality ratio of 6.8/100000 live births, a rate akin to other developed countries and consistent with the high level care provided within the Australian health care system. With maternal mortality at very low levels assessment of severe maternal morbidity is increasingly being used as an indicator of quality of care and to identify areas for improvement in maternity services. The WHO maternal 'near miss' criteria is a standardised tool has been increasingly used worldwide to assess maternal morbidity and standards of maternity care. The aim of this study was to determine the rate and aetiology of maternal 'near misses' at King Edward Memorial Hospital (KEMH) using the WHO near miss criteria.

Methods: Cases of maternal 'near miss' were prospectively identified at KEMH using the WHO near miss criteria over a period of 6 months (1st December 2014 to 31st May 2015). A descriptive analysis of the results was undertaken.

Results: During the study there were 2773 live births with 19 women who had 'near miss' presentations. There were no maternal deaths. The maternal 'near miss' index rate was 7/1000 live births. The main causes of obstetric 'near miss' were obstetric haemorrhage, pre-eclampsia and early pregnancy complications.

Conclusion: The rate of maternal 'near miss' at KEMH was 7/1000 live births and post-partum haemorrhage was identified as the most common aetiology, consistent with other studies in developed countries. Further research comparing currently utilised local, state and national morbidity systems would allow further validation of the WHO near miss criteria in Australian settings.

Item ID: 54425
Item Type: Article (Research - C1)
ISSN: 1471-2393
Keywords: near miss healthcare, severe maternal morbidity, pregnancy complications, maternal health, maternal mortality
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© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

Date Deposited: 04 Jul 2018 07:43
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3215 Reproductive medicine > 321502 Obstetrics and gynaecology @ 100%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920408 Health Status (e.g. Indicators of Well-Being) @ 100%
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