A Study of Feto Maternal Outcome in Severe Acute Maternal Morbidity (Samm)
Keywords:Severe acute maternal morbidity; maternal near miss; intensive care.
Background &Objectives: Severe acute maternal morbidity (SAMM), also known as “near miss”, is defined as “A very ill pregnant or recently delivered woman who would have died had it not been that luck and good care was on her side.” This concept which is relatively new in maternal care identifies health system failures or priorities in maternal health more rapidly than maternal deaths. This study was undertaken to document the frequency and nature of maternal near miss and to evaluate feto maternal outcome. Material &Methods: It is a prospective observational study conducted at Vanivilas hospital attached to BMCRI, Bangalore. All maternal near-miss cases which occurred between January 2013 to June 2014 at or after arrival at Vanivilas Hospital who were admitted to an intensive care unit (ICU) during pregnancy or in the Puerperium which met disease specific inclusion criteria was included in study. Results: In the study period 115 maternal near miss cases were admitted at ICU. 73.1% patients were uneducated, 78.3% were 20-29 years age group, 53.9% were from rural area, 88.7% of women belonged to low SES, 89.6% were referred, 67.8% were near miss at arrival, 57.4% were multigravida, 58.7% had delay in seeking care and 47.9% delivered vaginally. Mean duration of ICU stay was 4 days, intensive monitoring with blood transfusion (60.9%) was the most common intervention required at ICU. Hypertensive disorders (47%) followed by hemorrhage (27%) was leading cause for SAMM. Out of 115 SAMM patients 66 were alive babies, 8 were aborted, 19 were still born, and 22 were foetal deaths. Conclusion: In the present study it is concluded that illiteracy, low income, late referral, delay in seeking care were nature of SAMM. Hypertensive disorders and severe hemorrhage are the leading causes of SAMM and SAMM severely affects the perinatal outcome. An urgent review of the referral system and the emergency obstetric care is highly recommended to prevent Near miss.
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Copyright (c) 2021 Bhavya YR, Anusha GK, Renukamma H, Sunil Kumar P
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