Maternal Near Miss and Death Among Women with Eclampsia Using WHO Near Miss Criteria

The aim of the study was to estimate the prevalence of maternal near miss (MNM) and maternal death and to identify the factors associated with severe maternal outcome in women with eclampsia according to the World Health Organization (WHO) maternal near-miss criteria.

A cross-sectional study was carried out over a period of 12 months incorporating pregnant women diagnosed as eclampsia during antepartum and postpartum period. The definition of maternal near miss was applied according to the WHO near-miss criteria. Data were collected in a case record form specially designed for the study and analyzed using statistical software.

A total of 229 women with eclampsia included in the study over a period of 1 year. Among 229 women with eclampsia, 75 (32.75%) women diagnosed as maternal near miss (MNM), and 6 (2.62%) women had maternal death. Causes of near miss were neurological dysfunction (30.66%), respiratory dysfunction (24%), hematological dysfunction (18.67%), cardiological dysfunction (16%), hepatic dysfunction (10.67%) and uterine dysfunction (5.33%). Maternal near-miss ratio is 4.91 per 1000 live births, and severe maternal outcome ratio is 5.30 per 1000 live birth. Maternal near-miss mortality ratio (MNM:1MD) is 12.5:1, and mortality index is 7.40.

The study shows that there is scope to improve antenatal care and utilization of health facilities. Early diagnosis, good perinatal supervision and appropriate treatment can ameliorate many cases.