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Original Papers

The Ability of ICU Admission to Detect Maternal Near Misses as Defined By The Who Near-Miss Criteria

Authors:

G. Bower,

St George’s University of London, GB
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T. Dias ,

District General Hospital Ampara, Sri Lanka and Faculty of Medicine, University of Kelaniya, LK
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V. Shanmugaraja,

District General Hospital Ampara, LK
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M. Lee,

St George’s University of London, GB
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D Cooper,

St George’s University of London, GB
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H. Crofton,

St George’s University of London, GB
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S. Kumarasiri,

District General Hospital Ampara, LK
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T. Padeniya

District General Hospital Ampara, LK
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Abstract

Objective: to assess the ability of intensive care unit (ICU) admission in pregnancy, or the postpartum period, to detect cases of obstetric near-miss.

Methods: All obstetric admissions to the ICU were included retrospectively and data collected as specified by 2011 World Health Organization (WHO) guidelines on evaluating obstetrics near-misses between 2010 and 2013 in a Sri Lankan Hospital. Proportion of ICU admissions which fulfilled the WHO criteria for Severe Acute Maternal Morbidity (SAMM), maternal mortality ratio (MMR), maternal near-miss mortality ratio (MNM: MM)), and maternal near-miss ratio (MNMR) were analysed.

Results: A total of 9,608 live births were reported. 118 ICU admissions and four maternal deaths were analysed. MMR was 42 per 100,000. MNMR was 9.7 per 1000, and MNM: MM was 23:1. From all ICU admissions 99 cases (79.8%) met additional WHO near-miss criteria and were classified as true SAMM. Pregnancy-induced hypertensive disorders accounted for majority of ICU admissions (37.7%). Out of eight published studies from our region none of them had a MNM: MM higher than ours.

Conclusions: Obstetric near-misses may be over-diagnosed if ICU admission is considered an independent inclusion criterion for SAMM. Reporting the proportion of patients admitted to ICU which are true near-miss may illustrate differing admission thresholds for a given institution.

Sri Lanka Journal of Obstetrics and Gynaecology Vol.37(3) 2015: 31-37

DOI: http://doi.org/10.4038/sljog.v37i3.7762
How to Cite: Bower, G. et al., (2016). The Ability of ICU Admission to Detect Maternal Near Misses as Defined By The Who Near-Miss Criteria. Sri Lanka Journal of Obstetrics and Gynaecology. 37(3), pp.31–37. DOI: http://doi.org/10.4038/sljog.v37i3.7762
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Published on 22 Feb 2016.
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