title: "Near miss" obstetric events and maternal deaths in a tertiary care hospital: an audit.
abstract: OBJECTIVE
  (1) To determine the frequency of maternal near miss, maternal near miss incidence ratio (MNMR), maternal near miss to mortality ratio and mortality index. (2) To compare the nature of near miss events with that of maternal mortality. (3) To see the trend of near miss events.
  
  
  METHODS
  Audit.
  
  
  METHODS
  Kasturba Hospital, Manipal University, Manipal, India.
  
  
  METHODS
  Near miss cases & maternal deaths.
  
  
  METHODS
  Cases were defined based on WHO criteria 2009.
  
  
  METHODS
  Severe acute maternal morbidity and maternal deaths.
  
  
  RESULTS
  There were 7390 deliveries and 131 "near miss" cases during the study period. The Maternal near miss incidence ratio was 17.8/1000 live births, maternal near miss to mortality ratio was 5.6 : 1, and mortality index was 14.9%. A total of 126 cases were referred, while 5 cases were booked at our hospital. Hemorrhage was the leading cause (44.2%), followed by hypertensive disorders (23.6%) and sepsis (16.3%). Maternal mortality ratio (MMR) was 313/100000 live births.
  
  
  CONCLUSIONS
  Hemorrhage and hypertensive disorders are the leading causes of near miss events. New-onset viral infections have emerged as the leading cause of maternal mortality. As near miss analysis indicates the quality of health care, it is worth presenting in national indices.
authors.affiliation: Department of Obstetrics and Gynecology, Kasturba Hospital, Manipal University, Manipal, Karnataka 576104, India.
authors.forename: Roopa
authors.initials: R
authors.lastname: Ps
authors.forename: Shailja
authors.initials: S
authors.lastname: Verma
authors.forename: Lavanya
authors.initials: L
authors.lastname: Rai
authors.forename: Pratap
authors.initials: P
authors.lastname: Kumar
authors.forename: Murlidhar V
authors.initials: MV
authors.lastname: Pai
authors.forename: Jyothi
authors.initials: J
authors.lastname: Shetty
mesh_terms: D000328:Adult; D002423:Cause of Death; D016638:Critical Illness / Q000453:epidemiology / Q000401:mortality; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D063130:Maternal Death / Q000209:etiology / Q000706:statistics & numerical data; D008485:Medical Audit; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D062606:Tertiary Care Centers / Q000706:statistics & numerical data