{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T04:00:24Z","timestamp":1768449624702,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T00:00:00Z","timestamp":1683244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The World Health Organization (WHO) \u2018near miss\u2019 tool has been extensively used to audit maternal morbidity in low\u2010 and middle\u2010income countries. Analysis of the cases of \u2018near miss\u2019 enables a better understanding of the associated factors, identifies deficiencies in the provision of maternity services and lays a foundation for better preventive measures in the future.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To understand the epidemiology, aetiology and determine the aspects of preventability of maternal \u2018near miss\u2019 (MNM) at Kathmandu Medical College.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A prospective audit of MNM and maternal deaths (MD) was undertaken at Kathmandu Medical College over a period of 12\u2009months. The cases were identified using WHO \u2018near miss\u2019 criteria and areas of preventability in the provision of care determined using the modified Geller's criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total number of deliveries and live births in the study period were 2747 and 2698 respectively. A total of 34 \u2018near misses\u2019 and two MDs were identified. The common direct aetiologies of MNM and MDs identified were obstetric haemorrhage followed by hypertensive disorders with one\u2010third of cases being of indirect aetiology. Fifty\u2010five percent of cases had some aspects of provider\u2010 or system\u2010related preventability with the leading delays being lack of diagnosis and recognition of high\u2010risk status among patients and lack of interdepartmental communication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The WHO near miss rate at Kathmandu Medical College was 12.5\/100 live births. Significant aspects of preventability, especially at the level of the provider, were noted among cases of MNM and MDs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13679","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T11:24:48Z","timestamp":1683285888000},"page":"527-534","source":"Crossref","is-referenced-by-count":4,"title":["Maternal near miss at Kathmandu Medical College: An analysis of severe maternal morbidity at a Nepalese tertiary care facility"],"prefix":"10.1111","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0929-8240","authenticated-orcid":false,"given":"Rosina","family":"Manandhar","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, Nepal Mediciti  Lalitpur Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashmita","family":"Adhikari","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Chitwan Medical College  Chitwan Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naresh","family":"Manandhar","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, College of Medicine Nepalese Army Institute of Health Sciences  Kathmandu Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2730-7454","authenticated-orcid":false,"given":"Skandarupan","family":"Jayaratnam","sequence":"additional","affiliation":[{"name":"Canberra Hospital  Canberra Garran Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,5]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Nepal safe motherhood and newborn health road map 2030. 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