Khan Tabassum, Laul Poonam, Laul Anish, Ramzan Mohammed
Department of Obstetrics and Gynaecology, Deen Dayal Upadhyay Hospital, New Delhi, India.
Maulana Azad Medical College, New Delhi, India.
Int J Gynaecol Obstet. 2017 Aug;138(2):171-176. doi: 10.1002/ijgo.12208. Epub 2017 May 31.
To study maternal near miss (MNM) and maternal mortality to identify rectifiable risk factors.
The present cross-sectional retrospective study included pregnant women who experienced acute life-threatening pregnancy-related adverse events at Deen Dayal Upadhyay hospital, New Delhi, India, between September 1, 2009, and August 31, 2011. Patient data were analyzed to investigate factors associated with MNM events and maternal deaths.
There were 369 patients included, and 302 MNM events and 67 maternal deaths were recorded. The recorded causes of MNM events included hemorrhage, hypertensive disorders, severe anemia with cardiac failure, organ failure, and infection in 192 (63.6%), 62 (20.5%), 13 (4.3%), 8 (2.6%), and 8 (2.6%) patients, respectively. Higher rates of anemia (P=0.007) and infection (P=0.007) were recorded among patients in the maternal death group than the MNMN group.
Hemorrhage and hypertension were major causes of MNM events and are likely major barriers to reducing maternal mortality in low-income countries. Anemia and infection were significant prognostic factors of maternal death in the present study. MNM could be used as surrogate for maternal death in the provision of standard obstetric care.
研究孕产妇接近死亡（MNM）和孕产妇死亡情况，以确定可纠正的危险因素。
本横断面回顾性研究纳入了2009年9月1日至2011年8月31日期间在印度新德里迪恩·达亚尔·乌帕德亚伊医院经历与妊娠相关的急性危及生命不良事件的孕妇。对患者数据进行分析，以调查与MNM事件和孕产妇死亡相关的因素。
共纳入369例患者，记录到302例MNM事件和67例孕产妇死亡。记录的MNM事件原因包括出血、高血压疾病、重度贫血伴心力衰竭、器官衰竭和感染，分别有192例（63.6%）、62例（20.5%）、13例（4.3%）、8例（2.6%）和8例（2.6%）患者。孕产妇死亡组患者的贫血发生率（P = 0.007）和感染发生率（P = 0.007）高于MNM组。
出血和高血压是MNM事件的主要原因，可能是低收入国家降低孕产妇死亡率的主要障碍。在本研究中，贫血和感染是孕产妇死亡的重要预后因素。在提供标准产科护理时，MNM可作为孕产妇死亡的替代指标。
