Liyew Ewnetu Firdawek, Yalew Alemayehu Worku, Afework Mesganaw Fantahun, Essén Birgitta
Department of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS One. 2017 Jun 6;12(6):e0179013. doi: 10.1371/journal.pone.0179013. eCollection 2017.
Because maternal mortality is a rare event, it is important to study maternal near-miss as a complement to evaluate and improve the quality of obstetric care. Thus, the study was conducted with the aim of assessing the incidence and causes of maternal near-miss.
A facility-based cross-sectional study was conducted in five selected public hospitals of Addis Ababa, Ethiopia from May 1, 2015 to April 30, 2016. All maternal near-miss cases admitted to the selected hospitals during the study period were prospectively recruited. World Health Organization criteria were used to identify maternal near-miss cases. The number of maternal near-miss cases over one year per 1000 live births occurring during the same year was calculated to determine the incidence of maternal near-miss. Underlying and contributing causes of maternal near-miss were documented from each participant's record.
During the one-year period, there were a total of 238 maternal near-miss cases and 29,697 live births in all participating hospitals, which provides a maternal near-miss incidence ratio of 8.01 per 1000 live births. The underlying causes of the majority of maternal near-miss cases were hypertensive disorders and obstetric hemorrhage. Anemia was the major contributing cause reported for maternal near-miss. Most of the maternal near-miss cases occurred before the women's arrival at the participating hospitals.
The study demonstrated a lower maternal near-miss incidence ratio compared to previous country-level studies. The majority of the near-miss cases occurred before the women's arrival at the participating hospitals, which underscores the importance of improving pre-hospital barriers. Efforts made toward improvement in the management of life-threatening obstetric complications could reduce the occurrence of maternal near-miss problems that occur during hospitalization.
由于孕产妇死亡是罕见事件，研究孕产妇接近死亡情况作为评估和改善产科护理质量的补充很重要。因此，开展本研究旨在评估孕产妇接近死亡的发生率及原因。
2015年5月1日至2016年4月30日，在埃塞俄比亚亚的斯亚贝巴五家选定的公立医院开展了一项基于机构的横断面研究。前瞻性招募了研究期间入住选定医院的所有孕产妇接近死亡病例。采用世界卫生组织标准识别孕产妇接近死亡病例。计算同年每1000例活产中一年以上孕产妇接近死亡病例数，以确定孕产妇接近死亡的发生率。从每位参与者的记录中记录孕产妇接近死亡的潜在原因和促成原因。
在这一年期间，所有参与医院共有238例孕产妇接近死亡病例和29697例活产，孕产妇接近死亡发生率为每1000例活产8.01例。大多数孕产妇接近死亡病例的潜在原因是高血压疾病和产科出血。贫血是报告的孕产妇接近死亡的主要促成原因。大多数孕产妇接近死亡病例发生在妇女到达参与医院之前。
与之前的国家级研究相比，本研究显示孕产妇接近死亡发生率较低。大多数接近死亡病例发生在妇女到达参与医院之前，这突出了改善院前障碍的重要性。为改善危及生命的产科并发症管理所做的努力可以减少住院期间发生的孕产妇接近死亡问题。
