A DESCRIPTIVE STUDY ON MATERNAL NEAR MISS CASES IN A TERTIARY MEDICAL COLLEGE, KOLKATA

Abstract

Background: Maternal near miss (MNM) cases offer critical insights into the quality
of obstetric care and help identify preventable factors leading to severe maternal
outcomes. This study evaluated the incidence, causes, and management patterns of
MNM cases at a tertiary care hospital.
Methods: An observational, cross-sectional study was conducted over 18 months at
R.G. Kar Medical College & Hospital, Kolkata. A total of 203 MNM cases were
identified using WHO near miss criteria. Data were analyzed on sociodemographic,
obstetric profile, delays, interventions, and outcomes.
Results: The MNM incidence ratio was 9.19 per 1,000 live births, with a near miss
to mortality ratio of 6.15:1. Most patients were aged 20–29 years and multiparous.
Haemorrhage (43.8%) and hypertensive disorders (35.5%) were leading causes.
Significant delays in seeking and reaching care were observed in 72% and 92% of
cases, respectively. Interventions included blood transfusion (80.8%), ICU admission
(29.6%), and emergency surgeries.
Conclusion: Haemorrhage, hypertensive disorders, and systemic delays are major
contributors to MNM. Strengthening antenatal services, timely referrals, and critical
care capacity can improve maternal outcomes in similar resource-constrained
settings.