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Indicators for maternal near miss: an observational study, India

OBJECTIVE: To compare the incidence of maternal near miss using the World Health Organization (WHO) near-miss tool and six other criteria sets, including criteria designed for low-resource settings or specifically for India. METHODS: In a cohort study we used WHO severity indicators to identify wome...

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Autores principales: Balachandran, Divya Mecheril, Karuppusamy, Dhamotharan, Maurya, Dilip Kumar, Kar, Sitanshu Sekhar, Keepanasseril, Anish
Formato: Online Artículo Texto
Lenguaje:English
Publicado: World Health Organization 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9243687/
https://www.ncbi.nlm.nih.gov/pubmed/35813510
http://dx.doi.org/10.2471/BLT.21.287737
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author Balachandran, Divya Mecheril
Karuppusamy, Dhamotharan
Maurya, Dilip Kumar
Kar, Sitanshu Sekhar
Keepanasseril, Anish
author_facet Balachandran, Divya Mecheril
Karuppusamy, Dhamotharan
Maurya, Dilip Kumar
Kar, Sitanshu Sekhar
Keepanasseril, Anish
author_sort Balachandran, Divya Mecheril
collection PubMed
description OBJECTIVE: To compare the incidence of maternal near miss using the World Health Organization (WHO) near-miss tool and six other criteria sets, including criteria designed for low-resource settings or specifically for India. METHODS: In a cohort study we used WHO severity indicators to identify women with potentially life-threatening conditions during pregnancy or childbirth admitted to a referral hospital in Puducherry, India, from May 2018 to April 2021. We analysed sociodemographic, clinical and laboratory data for each woman and calculated the incidence of maternal near miss and other process indicators for each set of criteria. FINDINGS: We analysed data on 37 590 live births; 1833 (4.9%) women were identified with potentially life-threatening conditions, 380 women had severe maternal outcomes and 57 died. Applying the different sets of criteria to the same data, we found the incidence of maternal near miss ranged from 7.6 to 15.6 per 1000 live births. Only the Global Network criteria (which exclude laboratory data that may not be available in low-resource settings) and the WHO criteria could identify all women who died. Applying the criterion of any number of units of blood transfusion increased the overall number of women identified with near miss. CONCLUSION: The WHO and Global Network criteria may be used to detect maternal near miss in low-resource settings. Future studies could assess the usefulness of blood transfusion as an indicator for maternal near miss, especially in low- to middle-income countries where the indicator may not reflect severe maternal morbidity if the number of units received is not specified.
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spelling pubmed-92436872022-07-07 Indicators for maternal near miss: an observational study, India Balachandran, Divya Mecheril Karuppusamy, Dhamotharan Maurya, Dilip Kumar Kar, Sitanshu Sekhar Keepanasseril, Anish Bull World Health Organ Research OBJECTIVE: To compare the incidence of maternal near miss using the World Health Organization (WHO) near-miss tool and six other criteria sets, including criteria designed for low-resource settings or specifically for India. METHODS: In a cohort study we used WHO severity indicators to identify women with potentially life-threatening conditions during pregnancy or childbirth admitted to a referral hospital in Puducherry, India, from May 2018 to April 2021. We analysed sociodemographic, clinical and laboratory data for each woman and calculated the incidence of maternal near miss and other process indicators for each set of criteria. FINDINGS: We analysed data on 37 590 live births; 1833 (4.9%) women were identified with potentially life-threatening conditions, 380 women had severe maternal outcomes and 57 died. Applying the different sets of criteria to the same data, we found the incidence of maternal near miss ranged from 7.6 to 15.6 per 1000 live births. Only the Global Network criteria (which exclude laboratory data that may not be available in low-resource settings) and the WHO criteria could identify all women who died. Applying the criterion of any number of units of blood transfusion increased the overall number of women identified with near miss. CONCLUSION: The WHO and Global Network criteria may be used to detect maternal near miss in low-resource settings. Future studies could assess the usefulness of blood transfusion as an indicator for maternal near miss, especially in low- to middle-income countries where the indicator may not reflect severe maternal morbidity if the number of units received is not specified. World Health Organization 2022-07-01 2022-06-02 /pmc/articles/PMC9243687/ /pubmed/35813510 http://dx.doi.org/10.2471/BLT.21.287737 Text en (c) 2022 The authors; licensee World Health Organization. https://creativecommons.org/licenses/by/3.0/igo/This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (http://creativecommons.org/licenses/by/3.0/igo/legalcode (https://creativecommons.org/licenses/by/3.0/igo/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.
spellingShingle Research
Balachandran, Divya Mecheril
Karuppusamy, Dhamotharan
Maurya, Dilip Kumar
Kar, Sitanshu Sekhar
Keepanasseril, Anish
Indicators for maternal near miss: an observational study, India
title Indicators for maternal near miss: an observational study, India
title_full Indicators for maternal near miss: an observational study, India
title_fullStr Indicators for maternal near miss: an observational study, India
title_full_unstemmed Indicators for maternal near miss: an observational study, India
title_short Indicators for maternal near miss: an observational study, India
title_sort indicators for maternal near miss: an observational study, india
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9243687/
https://www.ncbi.nlm.nih.gov/pubmed/35813510
http://dx.doi.org/10.2471/BLT.21.287737
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