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Title: Maternal 'near miss' at Royal Darwin Hospital: An analysis of severe maternal morbidity at an Australian regional tertiary maternity unit.
Authors: Jayaratnam, Skandarupan
Burton, Alice
Connan, Kirsten Fiona
de Costa, Caroline
Affiliation: Royal Darwin Hospital, Darwin, NT, Australia.. Hospital Nacional Guido Valadares (HNGV), Dili, Timor-Leste..
Royal Darwin Hospital, Darwin, NT, Australia.. Royal Prince Alfred Hospital, Sydney, NSW, Australia..
Royal Darwin Hospital, Darwin, NT, Australia.. Tasmanian Obstetrics and Gynaecology Specialists - TasOGS, Hobart, TAS, Australia..
Department of Medicine and Dentistry, James Cook University (JCU), Cairns, Qld, Australia..
Issue Date: Aug-2016
Citation: The Australian & New Zealand journal of obstetrics & gynaecology 2016-08; 56(4): 381-6
Abstract: Assessment of severe maternal morbidity using World Health Organization (WHO) 'near-miss' criteria is gaining in importance as a valuable tool in the assessment of maternity care of women. Identification of cases allows an understanding of aetiology of severe morbidity and factors contributing to poor maternal outcomes. The aim of this study is to determine the rate of maternal 'near miss' at Royal Darwin Hospital (RDH) and the utility of the WHO near-miss criteria as a tool for data collection in a regional Australian context. Cases of maternal 'near miss' and deaths were prospectively identified over a period of 12 months using the WHO criteria. During the audit period, there were 2080 live births at Royal Darwin Hospital (RDH): 10 women presented with a 'near miss' and there was one maternal death. The maternal mortality ratio for the hospital was 48/100 000 live births, the maternal 'near-miss' index ratio was 4.8/1000 live births, and the combination of maternal deaths and near misses gave a severe maternal outcome (SMO) ratio of 5.3/1000 live births. The main cause of obstetric 'near miss' was obstetric haemorrhage. Indigenous women and women from remote areas comprised a significant portion of 'near-miss' cases. The rates of maternal 'near miss' at RDH are consistent with other studies in the developed world. The WHO maternal 'near-miss' audit tool helps health professionals understand and anticipate severe maternal morbidities, with the aim of improving maternal and perinatal outcomes.
DOI: 10.1111/ajo.12436
Type: Journal Article
Observational Study
Subjects: indigenous
Hospital Units
Maternal Mortality
Medical Audit
Near Miss, Healthcare
Northern Territory
Pregnancy Complications
Prospective Studies
Quality Indicators, Health Care
Tertiary Care Centers
Uterine Hemorrhage
World Health Organization
Appears in Collections:NT Health digital library

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