AN IN-DEPTH ASSESSMENT OF MATERNAL MORTALITY AND NEAR-MISSES DUE TO SEPSIS IN LOW-INCOME COUNTRY: PROSPECTIVE CROSS-SECTIONAL STUDY
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Keywords
Maternal near miss, Morbidity, Mortality, Cesarean section, Post natal infection, septic abortion
Abstract
Background: Post natal infection is a global health care issue and continues to be the leading cause of death in developing countries like Pakistan. The objective of this study was to determine the burden and factors associated with maternal near miss and mortality due to postnatal infections at tertiary care hospital.
Methodology: A prospective cross sectional study was conducted for one year in the department of OBGYN at Liaquat University of Medical and Health sciences Jamshoro from May 2021- April 2022. All women with post natal and post aborted infections identified as Near Miss or died were included in the study.
Result: Out of 143 women included in study, 95.1% women identified as Near Miss and 4.9% were expired. Majority of women (53.1%) were 25-36 years of age, belong to rural areas (62.9%) mostly uneducated, referred cases from primary and secondary care hospitals. There was no significant association of baseline maternal characteristics with maternal outcomes (P>0.05). (58.1%) near miss and (71.4%) maternal deaths cases have initial procedure of cesarean section there was a significant association of cesarean section with maternal near miss and mortality cases (p<0.01). The major causes of postnatal infections were peritonitis (39.2%), wound infection (30.1%) and septic abortion (20.3%). (76.2%) women received antibiotics before transfer to tertiary care hospital. Data was analyzed using SPSS version 23.0, Association of parameters with Maternal outcomes were tested using Chi Square test and Fisher’s Exact test (when n<5). P-values less than 0.05 were considered statistically significant.
Conclusion: Cesarean section and septic abortion were mainly associated with post natal infection. Local strategies and policies should be established and implemented to improve the quality, safety and infection control for postnatal period of women.
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Fehmida Parveen
FCPS, Associate Professor, Department of OBGYN, Liaquat University of Medical and Health Sciences, Jamshoro - Pakistan
Samia Aijaz
Clinical Fellowship in Urogynecology, Senior Registrar, OBGYN, Section of Urogynecology, Liaquat University of Medical and Health Sciences, Jamshoro – Pakistan
Sumera Malik
Clinical Fellowship in Urogynaecology, Consultant OBGYN Lady Dufferin Hospital, Karachi – Pakistan
Taha Noor Memon
A Levels Student, Foundation Public School, Hyderabad – Pakistan