Maternal mortality and morbidity remain public health problems in the developing countries influenced by access to health care and the quality of service provided. Assessment of Maternal Near Miss (MNM) will provide more information to improve the quality of obstetric care and to reduce maternal mortality and morbidity. This is a prospective cross-sectional study conducted at Omdurman Maternity Hospital (OMH) during 2013 to assess the occurrence of MNM and maternal mortality. Also, to identify the causes of MNM and determine the socio-demographic characteristics of women experiencing MNM and Maternal Death (MD). Modified WHO criteria (clinical, laboratory and management based) for identifying MNM were applied and the data was collected by reviewing all medical records using a structured data abstraction form. During the study period, a total of 305 women with life threatening conditions were identified at OMH: 260 MNM, 45 MD and 35863 Live Births (LB). Maternal Mortality Ratio (MMR) was 125/100000 LB, the Maternal Near Miss Incidence Ratio (MNMIR) was 7.2/1000 LB, MNM to MD ratio was 5.8:1 and the total mortality index was 14.8%. Haemorrhage was the most common cause of MNM, followed by eclampsia, sepsis, hepatitis, cardiac disease and other indirect events: 48.5%, 28.8%, 15.7%, 3.1%, 2.7% and 1.2 % respectively. Highest mortality index was caused by hepatitis, followed by cardiac disease, sepsis, eclampsia and haemorrhage: 46.7%, 22.2%, 12.8%, 11.8% and 8.1% respectively. Maternal mortality and morbidity remain challenging problems in this hospital, with hepatitis as an emerging cause of high mortality index. Progress can be made by improving the referral system, antenatal care (ANC) and hospital delivery, to prevent late presentation.
 

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