title: Maternal near-miss in a rural hospital in Sudan.
abstract: BACKGROUND
  Investigation of maternal near-miss is a useful complement to the investigation of maternal mortality with the aim of meeting the United Nations' fifth Millennium Development Goal. The present study was conducted to investigate the frequency of near-miss events, to calculate the mortality index for each event and to compare the socio-demographic and obstetrical data (age, parity, gestational age, education and antenatal care) of the near-miss cases with maternal deaths.
  
  
  METHODS
  Near-miss cases and events (hemorrhage, infection, hypertensive disorders, anemia and dystocia), maternal deaths and their causes were retrospectively reviewed and the mortality index for each event was calculated in Kassala Hospital, eastern Sudan over a 2-year period, from January 2008 to December 2010. Disease-specific criteria were applied for these events.
  
  
  RESULTS
  There were 9578 deliveries, 205 near-miss cases, 228 near-miss events and 40 maternal deaths. Maternal near-miss and maternal mortality ratio were 22.1/1000 live births and 432/100 000 live births, respectively. Hemorrhage accounted for the most common event (40.8%), followed by infection (21.5%), hypertensive disorders (18.0%), anemia (11.8%) and dystocia (7.9%). The mortality index were 22.2%, 10.0%, 10.0%, 8.8% and 2.4% for infection, dystocia, anemia, hemorrhage and hypertensive disorders, respectively.
  
  
  CONCLUSIONS
  There is a high frequency of maternal morbidity and mortality at the level of this facility. Therefore maternal health policy needs to be concerned not only with averting the loss of life, but also with preventing or ameliorating maternal-near miss events (hemorrhage, infections, hypertension and anemia) at all care levels including primary level.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Kassala University, Sudan. abuzianab73@yahoo.com
authors.forename: Abdel Aziem A
authors.initials: AA
authors.lastname: Ali
authors.forename: Awadia
authors.initials: A
authors.lastname: Khojali
authors.forename: Amira
authors.initials: A
authors.lastname: Okud
authors.forename: Gamal K
authors.initials: GK
authors.lastname: Adam
authors.forename: Ishag
authors.initials: I
authors.lastname: Adam
mesh_terms: D000328:Adult; D000740:Anemia / Q000401:mortality*; D005260:Female; D006780:Hospitals, Rural; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000401:mortality*; D008428:Maternal Mortality; D006473:Postpartum Hemorrhage / Q000401:mortality*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000401:mortality*; D012189:Retrospective Studies; D013397:Sudan / Q000453:epidemiology