Near miss maternal mortality in Jos University Teaching Hospital (JUTH), Jos, Plateau State Nigeria

Abstract

Background: Near misses are incidents which might have resulted in a maternal death, but for prompt and effective treatment. Characterizing near-miss mortality is valuable for monitoring the quality of hospital based obstetric care, and for assessing the incidence of life threatening complications. It is the major indicator used to monitor maternal health in the developed world, and it is also being increasingly used in Africa. For every woman who dies; many suffer serious life threatening complications of pregnancy. The near miss case definition was based on five diagnostic categories: Hypertensive disorder in pregnancy, haemorrhage, infections, labour dystocia, and severe anaemia
Aim- To determine the incidence of near-miss obstetric mortality in Jos University Teaching Hospital (JUTH) over a 12 month period

Method: Retrospective analysis of near-miss maternal morbidity from 1st January 2006 to 31st December 2006 was carried out. Data on maternal age, parity, diagnosis, booking status, duration of admission and treatment were collected. Analysis was done with EPI-Info, version 6 statistical software packages.

Result: There were 2,972 deliveries, and 73 near-miss cases. The incidence of near misses in the year under review was 2.5%, or 2,500 per 100,000 deliveries. Forty of the 73 case files were retrieved .Hypertensive disorders constituted 32.5%, and were the leading event. It was followed by haemorrhage (27.5%), infections (22.5%), dystocia (15%), and severe anaemia (2.5%). Majority (60%) of the cases were unbooked, many (27.5%) booked elsewhere, and only a small minority (12.5%) booked in this center.

Conclusion: Hypertensive disorders, haemorrhage, and infections were the leading near miss events in this center, and efforts should be made to further allocate more resources for managing these cases, especially in unbooked patients.