Maternal near miss review from a tertiary care center in South India

Background: Maternal near miss review acts as complimentary for mortality audits. It indicates the quality of obstetric care and helps obstetricians to revise policies and practices.Methods: A retrospective observational study was carried out at institute of maternal and child health, Government Medical College Kozhikode from January to December 2014. Cases were defined based on WHO criteria 2009.Results: Total live births during the study period were 15604 and there were 24 maternal deaths. Near Miss cases were 267. Maternal mortality rate was 153.5/lakh live births and maternal near miss incidence ratio was 17.03/1000 live births. Maternal near miss to mortality ratio was 11.1 and mortality index was 8.2%. Hypertensive disorders comprised 46%, followed by haemorrhage 36%, sepsis 7% and other causes 10%.Conclusions: Even with improving care, maternal near miss incidence (17.03 per 1000 live births) is found to be higher in our institution compared to developed nations. However high maternal near miss to mortality ratio (11.1) and low mortality index (8.2%) shows good quality of obstetric care in our institution