Best Practice & Research Clinical Obstetrics & Gynaecology
1Maternal near miss – towards a standard tool for monitoring quality of maternal health care☆
Section snippets
Terminology and definition
“Near miss” and “severe acute maternal morbidity - SAMM” are the two terms used interchangeably for a “severe, life-threatening obstetric complication.” Borrowed from the airline industry, “near miss” in health care literature generally describes a condition that did not result in injury, illness, or damage - but had the potential to do so.15 However, in the context of maternal health, the near miss term has been historically used referring to a condition where a woman experienced a severe
Identification of maternal near miss cases
The next step is to define a set of criteria with which “a woman who nearly died but survived a complication” or a maternal near miss case can be identified. The criteria selected must be locally usable and relevant 18 while allowing comparisons between different sites, areas or ideally countries. There are three main approaches to select cases that would qualify as a maternal near miss. These are described in Table 1.
As discussed within the WHO systematic review of maternal near miss, each of
Summary and conclusions
Maternal mortality is among the worst performing health indicators in resource-poor settings despite increased global attention for its reduction. For those deaths occurring in health facilities, it is crucial to understand the processes of obstetric care in order to address any identified weakness or failure within the system. Maternal death reviews, if implemented consistently, could provide valuable information. However, although a significant public health problem, maternal deaths still are
Acknowledgements
The following individuals were among the members of the WHO working group that developed the identification criteria for maternal near miss (Affette McCaw-Binns, Ahmet Metin Gulmezoglu, Anoma Jayathilaka, Buyanjargal Yadamsuren, Cleone Rooney, João Paulo Souza, Jon Barrett, José Guilherme Cecatti, Lale Say, Linda Bartlett, Mary Ellen Stanton, Mohamed Cherine Ramadan, Nynke van den Broek, Robert C Pattinson, Rogelio Gonzalez, Veronique Filippi). We thank Jelka Zupan, Joaquin G Gomez Davila, and
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