dc.contributor.author | Koba, Geoffrey K | |
dc.date.accessioned | 2013-05-23T06:32:23Z | |
dc.date.available | 2013-05-23T06:32:23Z | |
dc.date.issued | 2007 | |
dc.identifier.citation | Master of medicine in obstetrics and gynaecology | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/11295/24588 | |
dc.description.abstract | Background: Near-Miss morbidities are non-fatal outcomes of life threatening conditions.
Near-miss maternal morbidity and its relation to maternal mortality have been proposed as
a more sensitive measure of pregnancy outcome than mortality alone. Data collected on
near-miss has been shown to be a mechanism for identifying health system failures or
priorities in maternal health care more rapidly than maternal deaths.
Objective: To determine the prevalence and characteristics of Near-Miss maternal
morbidity at PGH. Nyeri.
Design: This was a retrospective cross-sectional study.
Setting: The study was carried out at the maternity unit. PGH Nyeri.
Materials and Methods: A structured data collection tool was used to collect information
by abstraction from patient's medical records. The subjects were patients who had been
treated for near-miss morbidities between 28 weeks gestation and 42 days postpartum.
A total of 98 patients treated between October 2006 and March 2007 had their notes
reviewed: nine did not meet the inclusion criteria and were excluded, while the remaining
89 were all included in the study. Data entry was done using EPr-INFO software and
analysis conducted using STA TA 9.
Results: The prevalence of near-miss maternal morbidity was 3.7% of all deliveries that
took place during the duration of the study. The mean age of patients was 28.3 years (range
16-42 years). Adolescent patients were 12°;(). Primigravidas were 28%). Ninety three
percent of all the patients attended ANC. Common causes of near-miss events were
hypertensive diseases (37%), haemorrhage (27%), obstructed labour (16%) and sepsis
(7%). Sixty three percent of patients were delivered by caesarean section. Live births were
72%, FSB 20% and MSB 8%. Patients who were referred for dialysis were 7%. Maternal
deaths during the duration of study were 7% of all near-miss morbidities. giving a
mortality index of I: 15. Causes of maternal deaths were HIV IAIDS complications (50%).
hypertensive diseases (33%) and Haemorrhage (17%). Patients delivered by caesarean
section had a better fetal outcome than those who delivered vaginally (p-value 0.005). and delivery by caesarean section had a better maternal outcome than vaginal delivery (p-valuc
0.011 ).
Conclusion: Common causes of near-miss maternal morbidities were hypertensive
diseases and haemorrhage. There were 15 times more near-misses compared to maternal
deaths. Therefore, near-miss morbidities provide a larger sample to assess the threat to
maternal life than maternal mortalities in this centre.
Recommendation: Attempts to reduce near-miss morbidities in this hospital can be
achieved by good management of hypertensive diseases of pregnancy and haemorrhage.
Protocols on management of these conditions should be put in place and regularly updated. | en |
dc.description.sponsorship | University of Nairobi | en |
dc.language.iso | en | en |
dc.title | Case records and commentaries in obstetrics and gynaecology | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.publisher | Department of Paediatrics and Child Health, College of Health Sciences, University of Nairobi, | en |