{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:17:46Z","timestamp":1780499866464,"version":"3.54.1"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T00:00:00Z","timestamp":1592438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The rarity of maternal deaths in developed countries has increased interest in auditing cases of severe maternal morbidity or maternal \u2018near miss\u2019. The assessment and preventability of cases of maternal \u2018near misses\u2019 are important in improving the provision of maternity care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To describe the epidemiology and determine aspects of preventability in care among women admitted to an obstetric intensive care unit (ICU) in Far North Queensland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A retrospective observational study of pregnant and postpartum patients admitted to the Cairns Hospital ICU between 1 January 2013 and 31 December 2017 was undertaken. Cases of severe maternal morbidity were identified using the World Health Organization (WHO) \u2018near miss\u2019 criteria and reviewed to determine reasons for admission to ICU and ascertain aspects of preventability in the care provided.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010nine out of 12\u00a0081 (0.6%) women admitted for obstetric care were transferred to the ICU with 31 cases fulfilling WHO \u2018near miss\u2019 criteria. The most common direct obstetric\u2010related diagnosis for ICU admission was hypertensive disease of pregnancy and obstetric haemorrhage. Indirect obstetric causes contributed to approximately 40% of ICU admissions. Among the 31 cases of WHO \u2018near miss\u2019, ten cases were deemed preventable with the most common reason for preventability related to lack of recognition of high\u2010risk clinical status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Maternal \u2018near miss\u2019 and rates of obstetric admission to the ICU at Cairns Hospital are reassuringly low. Nevertheless, one\u2010third of women with \u2018near miss\u2019 required improvements in the provision of care, emphasising the need for continued audit and improvement of clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13198","type":"journal-article","created":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T10:38:44Z","timestamp":1592476724000},"page":"871-876","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Characteristics and preventability of obstetric intensive care unit admissions in Far North Queensland"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2730-7454","authenticated-orcid":false,"given":"Skandarupan","family":"Jayaratnam","sequence":"first","affiliation":[{"name":"College of Medicine and Dentistry Cairns Clinical School James Cook University Cairns Queensland Australia"},{"name":"Women's Health Unit Cairns Hospital Cairns Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Jacob\u2010Rodgers","sequence":"additional","affiliation":[{"name":"Department of Obstetric &amp; Gynaecology Ipswich Hospital Ipswich Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4994-7196","authenticated-orcid":false,"given":"Caroline","family":"de Costa","sequence":"additional","affiliation":[{"name":"College of Medicine and Dentistry Cairns Clinical School James Cook University Cairns Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,18]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Australian Institute of Health and Welfare \u2013 Maternal deaths in Australia 2012\u20132014. 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