Summary:
A near miss or severe acute maternal morbidity (SAMM)
means a woman (in pregnancy /labour/puerperium) who
was almost dead but survived. It is often poor, socially
excluded women that suffer most.
The objective of this study was to explore the outcome of
near miss cases admitted in the hospital along with their
presentation, socio demographic characteristic and medical
and surgical intervention needed.
It was a cross sectional study conducted from 1st July 2009
to 31st December 2009 at Institute of Child and Mother
Health. Among cases who got admitted in the hospital in
moribund condition with pregnancy related complications.
Total 91 patients were enrolled consecutively. Data were
collected by structured questionnaires. Analysis was done
using SPSS program.
About 72% of women were at second decade of their lives
and 71% of them were from poor socioeconomic condition.
About 39% patients did not take any antenatal checkup.  Eclampsia (43%) was the prime cause of SAMM. Next were
postpartum haemorrhage (17%), obstructed labour (11%),
antepartum haemorrhage (6%), ectopic pregnancy (6%),
chorioamnionitis (4%), severe preeclampsia (4%), septic
abortion (2%), ruptured uterus (2%), uterine perforation
(1%), shock (2%), puerperal sepsis (1%), and severe
anaemia (1%). Along with medical care, surgical
intervention such as LUCS, D&C, salphingoophorectomy,
hysterectomy were needed for the management of SAMM.
More than 4 bags of blood transfusion needed in 24.50%
of patients. Only 4% patients needed ICU admission.
Most of the causes of SAMM were apparently preventable.
Awareness and education about the danger signs of
pregnancy, proper antenatal care, delivery by skilled birth
attendant and proper auditing of care provided will be
helpful to prevent SAMM.
Key Words: Near miss, Outcome of pregnancy, Severe acute
maternal morbidity (SAMM).
(J Bangladesh Coll Phys Surg 2018; 36: 20-25)