Shoma Patnaik
Panaji
With maternal mortality being a key indicator of the quality of women’s healthcare in a state, a study on Maternal Near Miss (MNM) cases at the Goa Medical College (GMC) has revealed that of 54 women admitted with critical pregnancy-related complications, 45 survived while nine died.
The study, conducted by Dr Pallavi Giri, Dr Muriel Cardoso, and Dr Jagadish Cacodkar, reports Goa’s MNM to maternal mortality ratio at 5:1, meaning for every five women who survived a severe maternal complication, one
woman died.
The MNM incidence ratio is 8.05 per 1,000 live births, while the severe maternal morbidity outcome ratio is 9.66 per 1,000 live births. Goa’s mortality index is recorded at 16.66%, comparable to neighbouring Maharashtra and Karnataka.
“A low mortality index of 16% is indicative of good healthcare provided in spite of pregnant women being referred with severe illness,” the study said.
Published in the Journal of the Indian Medical Association in July 2025, the study finds that while MNM affects all age groups, young mothers aged 20-29 are most commonly affected. The youngest MNM case was 17 and the oldest was 46, with the median age being 25.
According to the study, 64% of women referred to GMC in a critical condition became MNM cases on admission. Notably, 82% of MNM cases were of women who had not registered at any hospital before or during pregnancy. The authors said this underlines the importance of education and early antenatal care.
The study was conducted over 18 months from November 2018 to April 2020, and included both, GMC-registered patients and those referred from public and private hospitals. GMC is the state’s only tertiary care hospital and also receives referrals from bordering districts of Maharashtra and Karnataka.
As per the World Health Organisation (WHO), MNM refers to women who narrowly survive life-threatening complications during pregnancy, childbirth or within 42 days of pregnancy termination. The analysis of MNM helps identify failures in the healthcare system, delays in care and areas needing intervention from the first hospital visit to final delivery.
The Union government introduced MNM operational guidelines in 2014, based on WHO norms, and they have been in force in Goa since 2018. The current study is the first of its kind in Goa and among the earliest conducted in India, based on available published literature.
