Effect of Instructional Guidelines on Maternity Nurses' Awareness Toward High Risk Pregnancy and Maternal Near Miss Cases

Maternal morbidity is defined as ill-health in a woman during pregnancy, irrespective of pregnancy site or duration, which is caused or aggravated by the pregnancy or its management, but which is not caused by accident or incident. This concept ranges from mild to severe maternal morbidity (SMM). Maternal near-miss (MNM) and potentially life-threatening conditions (PLTCs) are included as SMM.(Mekonnen et al., 2021) . Maternal mortality is an indicator of many parameters of maternal health, such as women's status, access to care and quality of care in low resource settings.(Mohammed et al., 2020) Maternal near-miss precedes maternal mortality, and women are still alive indicating that the numbers of near-misses occur more often than maternal mortality.(Mekonnen et al., 2021) Maternal near miss case is defined as "a woman who nearly died but survived a complication that occurred during pregnancy, childbirth, or within 42 days of termination of pregnancy"(Ninama et al., 2022) High risk pregnancy is defined as one where pregnancy is complicated by factor or factors that adversely affects the outcome- maternal or perinatal or both. Women with high-risk pregnancies should receive care from a special team of health care providers to ensure the best possible outcomes. (Arjariya & Tiwari, .2021) .High-risk pregnancy was classified based on the guidelines provided by Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) for identification of high-risk pregnancy by health-care workers. The parameters considered for diagnosis of high- risk pregnancy were also defined as per the guidelines provided by PMSMA. Antenatal women with the following conditions were categorized under high-risk pregnancy: a. Severe anemia with hemoglobin level 140/90 mmHg) b. Hypertensive disorder in pregnancy (blood pressure >140/90 mmHg) c. Previous history of lower segment cesarean section d. Bad obstetric history (history of obstructed labor) e. Low-lying placenta or placenta previa. .(Arjariya & Tiwari.,2021)