MATERNAL HEALTH CARE IN TERTIARY HOSPITAL IN TERMS OF MATERNAL NEAR MISSES (MNM) INDICATORS.

Objective: To assess maternal health care by proxy indicators in terms of frequency of near misses, Maternal Near Miss (MNM) ratio and Mortality Index in a tertiary care, Lady Reading, hospital.   Methodology: It was a Cross-sectional descriptive case study conducted in Obstetrics A unit of Lady Reading Hospital from January, 2019 to December, 2019.The WHO near miss “severe maternal complication” based inclusion criteria was used for case identification. The study population consisted of all women who were admitted during pregnancy, labor, or within the first 42 days of postpartum to our unit. Outcome was measured using the three indicators i.e. the mortality indices, maternal mortality ratio, mortality to near miss ratio, near miss cases/1000 deliveries     Results: Total cases included in this study were 10439. The total Maternal Near Miss cases were 1776 (1.84%). Maternal Near Miss Rate MNMR was calculated as 170 per 1000 live births. There were 44 total maternal deaths, and maternal mortality rate was calculated as 421 per 100,000 live births. The Maternal Near Miss to Mortality ratio was 41:1. Mortality Index was 2.5%.   Conclusion: Our hospital has a higher maternal near miss to mortality ratio of 41:1 showing good maternal care management. The WHO near miss indicators can be used in tertiary care care settings to evaluate the standard of care especially so in developing countries like Pakistan.   Keywords: maternal near-miss, near miss indicators mortality index, maternal mortality.