H, which might have the challenges of bias, lack of information and facts on vital confounding variables and incomplete information and facts from poor documentation. In contrast, the existing study can be a potential investigation of near misses occurring get ALS-8176 within a tertiary hospital in south western Nigeria. It documents the incidence and traits of close to misses more than a one particular year period working with a threelevel conceptual framework (Figure ); the framework was according to the operate of Reynold and collegues who investigated near miss materl events in Senegal and is an adaptation of the framework origilly created by McCathy and Maine. The framework facilitated the identification of critical associated components at the level of patient, socioenvironmental and overall health systems. Our study also examined the perital outcomes linked with lifethreatening materl morbidity in Nigeria.MethodsStudy settingThe study, a potential case manage study, was carried out in the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), IleIfe, SouthWestern Nigeria from July to June. OAUTHC can be a multicenter EPZ031686 facility that serves because the lead referral center in Osun State and neighbouring Ondo and Ekiti States having 
a combined population of more than ten million. The hospital has two tertiary units Wesley Guild Hospital, Ilesa and Ife Hospital Unit, IleIfe. The study was performed simultaneously in the two tertiaryAdeoye et al. BMC Pregncy and Childbirth, : biomedcentral.comPage ofFigure Conceptual framework for near misses materl morbidity.units; each deliver 
emergency obstetric care and have complete complement of materl health and neotal care infrastructures and service providers including obstetricians, anesthesiologists, neotologists, laboratory scientists and nursemidwives. Even though the study period was oneyear, there have been periods in the course of which the study was interrupted as an example in the course of industrial crises by wellness workers and so on; as such the price for miss reported in this study was for an interrupted sixmonth period. The study protocol was approved by Ethics and Study Committee on the PubMed ID:http://jpet.aspetjournals.org/content/189/1/185 hospital. Informed consent was obtained in the study participants and participation was voluntary.Study population, sample size and selectionThe study population consisted of pregnt girls who sought care at the hospitals for the duration of antetal (third trimester), intrapartum or inside days right after delivery. A materl close to miss was defined as any lady who skilled a lifethreatening complication and who nearly died but for the hospital care she received. The operatiol definitions for the near miss were based on the diseasespecific criteria described by Filippi et al. which was also utilized by Oladapo et al. in a study on close to misses inSagamu, Nigeria. They are (i). Haemorrhage (major to shock, emergency hysterectomy, coagulation defects, and or blood transfusion of or far more litres of blood); (ii). Hypertensive issues in pregncy eclampsia and extreme preeclampsia with clinical or laboratory indication for termition of pregncy to save the woman’s life (iii). Dystocia uterine rupture and impending rupture e.g. prolonged obstructed labour with previous caesarian section); (iv). Infection septicaemia from any cause; (v). Severe aemia: (hemoglobin gdl). For every close to miss case, 4 unmatched hospital controls have been selected within a defined time limit of hours around the close to miss event. Near misses events had been identified by resident physicians in labour ward according to the abovementioned criteria. The wom.H, which might have the challenges of bias, lack of facts on vital confounding variables and incomplete facts from poor documentation. In contrast, the present study can be a potential investigation of close to misses occurring inside a tertiary hospital in south western Nigeria. It documents the incidence and characteristics of near misses over a one particular year period using a threelevel conceptual framework (Figure ); the framework was based on the function of Reynold and collegues who investigated close to miss materl events in Senegal and is definitely an adaptation in the framework origilly created by McCathy and Maine. The framework facilitated the identification of critical associated components at the degree of patient, socioenvironmental and overall health systems. Our study also examined the perital outcomes related with lifethreatening materl morbidity in Nigeria.MethodsStudy settingThe study, a prospective case handle study, was carried out in the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), IleIfe, SouthWestern Nigeria from July to June. OAUTHC can be a multicenter facility that serves as the lead referral center in Osun State and neighbouring Ondo and Ekiti States with a combined population of more than ten million. The hospital has two tertiary units Wesley Guild Hospital, Ilesa and Ife Hospital Unit, IleIfe. The study was carried out simultaneously at the two tertiaryAdeoye et al. BMC Pregncy and Childbirth, : biomedcentral.comPage ofFigure Conceptual framework for close to misses materl morbidity.units; each give emergency obstetric care and have complete complement of materl well being and neotal care infrastructures and service providers like obstetricians, anesthesiologists, neotologists, laboratory scientists and nursemidwives. Although the study period was oneyear, there had been periods in the course of which the study was interrupted as an illustration in the course of industrial crises by overall health workers and so on; as such the price for miss reported within this study was for an interrupted sixmonth period. The study protocol was authorized by Ethics and Investigation Committee of the PubMed ID:http://jpet.aspetjournals.org/content/189/1/185 hospital. Informed consent was obtained from the study participants and participation was voluntary.Study population, sample size and selectionThe study population consisted of pregnt females who sought care in the hospitals through antetal (third trimester), intrapartum or within days right after delivery. A materl near miss was defined as any lady who seasoned a lifethreatening complication and who almost died but for the hospital care she received. The operatiol definitions for the close to miss were according to the diseasespecific criteria described by Filippi et al. which was also utilized by Oladapo et al. in a study on close to misses inSagamu, Nigeria. They are (i). Haemorrhage (top to shock, emergency hysterectomy, coagulation defects, and or blood transfusion of or far more litres of blood); (ii). Hypertensive problems in pregncy eclampsia and serious preeclampsia with clinical or laboratory indication for termition of pregncy to save the woman’s life (iii). Dystocia uterine rupture and impending rupture e.g. prolonged obstructed labour with prior caesarian section); (iv). Infection septicaemia from any lead to; (v). Extreme aemia: (hemoglobin gdl). For each and every near miss case, 4 unmatched hospital controls had been chosen within a defined time limit of hours about the near miss event. Near misses events have been identified by resident physicians in labour ward as outlined by the abovementioned criteria. The wom.
