Maternal near miss: A comprehensive analysis of severe maternal morbidity and mortality at a tertiary referral center

Abstract

Aim: Our aim is to evaluate the cases that are followed in our hospital and meet the maternal near miss (MNM) criteria and to contribute to the management of these cases in the light of this information.

Materials and Methods: Our study was conducted retrospectively. Data of 50 pregnant women who were treated in intensive care between 2022 and 2024 and met the MNM criteria of the World Health Organization (WHO) were collected from the hospital registry system. Information about the cases, laboratory results, clinical follow-up data and newborn data were obtained from the hospital registry system. Descriptive statistics were used to evaluate the cases.

Results: The mean maternal age was 30.55 ± 5.95 years, with a median BMI of 28 (IQR: 7). Most of the MNM cases occurred antenatally (46%) or intrapartum (34%). Hypertensive disorders, including gestational hypertension (42%), preeclampsia (40%), and HELLP syndrome (14%), were the leading causes of MNM, followed by hemorrhagic disorders such as postpartum atony (12%) and placenta previa (10%). Medical conditions, such as cardiovascular disease (18%) and diabetes (14%), were also significant contributors. Overall, 64% of patients recovered without sequelae, while 28% experienced long-term effects, and 3 patients (6%) died. The maternal mortality ratio (MMR) was 12.23 per 100,000 live births, and the maternal near miss ratio (MNMR) was 2.04 per 1,000 live births, with a mortality index of 5.66%.

Conclusion:  Consistent with previous results, hypertensive and hemorrhagic diseases were shown to be the most important causes of maternal near miss events. Maternal morbidity was also increasingly influenced by chronic medical disorders. However, high MNMR and mortality index indicate the need for effective management of serious maternal complications. The study underscores the importance of early detection, timely intervention, and multidisciplinary care in managing maternal near miss cases. To enhance maternal health outcomes, more work must be done.