Severe maternal complications in near missed mothers in Shahid Mostafa Khomeini Hospital- Tehran: 2015-2019

To better evaluate the quality of midwifery care, an index called "near miss" mothers is used. The term refers to the mothers who have gone near to death due to complications of pregnancy or childbirth, but survived. This study was performed with aim to investigate the prevalence and causes of severe complications of maternal and near miss mothers.

This retrospective study was performed on patients' records in Shahid Mostafa Khomeini Hospital from 2015-2016. The required variables including demographic information and severe pregnancy complications were extracted from patients' records according to the instructions of the World Health Organization. Data were analyzed using SPSS statistical software (version 25) and paired chi-square and Mann-Whitney tests. P≤0.05 was considered statistically significant.

Among 16,527 live births, 191 mothers suffered from severe maternal complications, of which 35 (17.3%) had near-miss and 2 maternal death. The ratio of near-miss mothers was 2.09 and the ratio of severe maternal complications was 11.40. The most important causes of severe complications were severe preeclampsia (n=134, 70.15%), severe obstetric bleeding (n=23, 12.4%) and sepsis (n=10, 5.23%). In cases of near-missed mothers, 19 cases (9.94%) had coagulation disorders, 9 (41.71%) had cardiovascular disorders, and 8 (4.18%) had kidney disorders. According to the results of logistic test, a significant relationship was found between anemia (p = 0.01) and severe preeclampsia (P = 0.006) in near-miss mothers and severe complications.

Essential delivery interventions including management of preeclampsia-eclampsia and its complications and the importance of maternal anemia during hospitalization play a vital role in reducing severe maternal complications.