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- DOI 10.18231/j.ijogr.v.12.i.3.23
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CrossMark
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Is maternal mortality ratio an outdated indicator of obstetric care in a tertiary care hospital?
Background: High-risk pregnancies are associated with increased maternal morbidity and mortality, particularly when complications that threaten the life of the mother arise. This study analysed the maternal outcomes of pregnancies with potentially life-threatening complications (PLTCs), near misses, and mortality with the aim of identifying key risk factors and trends.
Materials and Methods: This prospective cross-sectional study was conducted at KAHER’s Dr. Prabhakar Kore Hospital, Belagavi, over a one-year period from February 2023 to January 2024. The study included 239 pregnant women with potentially life-threatening conditions (PLTC) during pregnancy, labour, or the postpartum period, based on the WHO Health Organization criteria, and was approved by the institutional ethical committee. Data on maternal demographics, obstetric history, complications, interventions, and outcomes were collected using structured forms and interviews, ensuring confidentiality. Statistical analysis was performed using SPSS software, with chi-square tests and logistic regression models to identify associations between maternal outcomes and delays, and indices were presented as rates, ratios, and percentages.
Results: The study period encompassed a total of 4083 deliveries in one year, resulting in 4183 live births. During this period, severe maternal outcomes (PLTC and MNM) were recorded, including 4 maternal deaths and 34 maternal near-miss cases, with 239 potentially life threatening conditions. The incidence of near miss events was calculated to be 8.32 per 1000 deliveries and 8.12 per 1000 live births. The NMMR was observed to be 8.5, indicating that for every maternal death, there were 8.5 instances of near-miss events. The MMR was 95.62 per 100,000 live births per year and MMI was noted to be 10.5%. The maternal near misses to mortality ratios as well as the morbidity mortality index offer insights into the quality of healthcare provided at a centre. The higher ratio of maternal near-miss to mortality suggests good obstetric care and hospital facilities.
Conclusion: Timely intervention and appropriate management of potentially life-threatening conditions play critical roles in improving maternal outcomes. Despite variations in demographic and clinical factors, early detection and targeted care remain the key to reducing mortality and severe complications in maternal health. MNM, MNMMR, MMI give valuable insights into the obstetric care of a tertiary care hospital.