H, which might have the challenges of bias, lack of facts on vital confounding variables and incomplete info from poor documentation. In contrast, the present study is a potential investigation of close to misses occurring inside a tertiary Valbenazine TCS-OX2-29 site hospital in south western Nigeria. It documents the incidence and characteristics of close to misses more than a a single year period applying a threelevel conceptual framework (Figure ); the framework was based on the work of Reynold and collegues who investigated close to miss materl events in Senegal and is definitely an adaptation with the framework origilly created by McCathy and Maine. The framework facilitated the identification of essential linked elements at the degree of patient, socioenvironmental and 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 Complicated (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 having a combined population of over ten million. The hospital has two tertiary units Wesley Guild Hospital, Ilesa and Ife Hospital Unit, IleIfe. The study was carried out simultaneously in the two tertiaryAdeoye et al. BMC Pregncy and Childbirth, : biomedcentral.comPage ofFigure Conceptual framework for close to misses materl morbidity.units; both give emergency obstetric care and have complete complement 
of materl overall health and neotal care infrastructures and 
service providers like obstetricians, anesthesiologists, neotologists, laboratory scientists and nursemidwives. Even though the study period was oneyear, there have been periods throughout which the study was interrupted for example through industrial crises by health workers and so on; as such the rate for miss reported within this study was for an interrupted sixmonth period. The study protocol was approved by Ethics and Investigation Committee from 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 women who sought care in the hospitals for the duration of antetal (third trimester), intrapartum or inside days after delivery. A materl close to miss was defined as any woman who seasoned a lifethreatening complication and who nearly died but for the hospital care she received. The operatiol definitions for the near miss were according to the diseasespecific criteria described by Filippi et al. which was also utilized by Oladapo et al. inside a study on close to misses inSagamu, Nigeria. These are (i). Haemorrhage (leading to shock, emergency hysterectomy, coagulation defects, and or blood transfusion of or much more litres of blood); (ii). Hypertensive issues 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 previous caesarian section); (iv). Infection septicaemia from any trigger; (v). Extreme aemia: (hemoglobin gdl). For just about every near miss case, four unmatched hospital controls were chosen inside a defined time limit of hours about the close to miss occasion. Close to misses events have been identified by resident medical doctors in labour ward according to the abovementioned criteria. The wom.H, which may have the challenges of bias, lack of information on crucial confounding variables and incomplete information from poor documentation. In contrast, the present study is actually a prospective investigation of close to misses occurring within a tertiary hospital in south western Nigeria. It documents the incidence and qualities of near misses over a a single year period using a threelevel conceptual framework (Figure ); the framework was depending on the work of Reynold and collegues who investigated close to miss materl events in Senegal and is an adaptation from the framework origilly created by McCathy and Maine. The framework facilitated the identification of important connected elements at the level of patient, socioenvironmental and health systems. Our study also examined the perital outcomes associated with lifethreatening materl morbidity in Nigeria.MethodsStudy settingThe study, a potential case handle study, was carried out in the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), IleIfe, SouthWestern Nigeria from July to June. OAUTHC is a multicenter facility that serves because the lead referral center in Osun State and neighbouring Ondo and Ekiti States with a combined population of over ten million. The hospital has two tertiary units Wesley Guild Hospital, Ilesa and Ife Hospital Unit, IleIfe. The study was conducted simultaneously at the two tertiaryAdeoye et al. BMC Pregncy and Childbirth, : biomedcentral.comPage ofFigure Conceptual framework for near misses materl morbidity.units; both give emergency obstetric care and have full complement of materl health and neotal care infrastructures and service providers including obstetricians, anesthesiologists, neotologists, laboratory scientists and nursemidwives. Although the study period was oneyear, there were periods during which the study was interrupted for example in the course of industrial crises by health workers and so on; as such the rate for miss reported within this study was for an interrupted sixmonth period. The study protocol was authorized by Ethics and Research 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 women who sought care in the hospitals during antetal (third trimester), intrapartum or inside days just after delivery. A materl near miss was defined as any woman who experienced a lifethreatening complication and who nearly died but for the hospital care she received. The operatiol definitions for the near miss had been determined by 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 extra litres of blood); (ii). Hypertensive issues in pregncy eclampsia and severe 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 earlier caesarian section); (iv). Infection septicaemia from any lead to; (v). Extreme aemia: (hemoglobin gdl). For every close to miss case, 4 unmatched hospital controls have been selected inside a defined time limit of hours about the close to miss occasion. Near misses events had been identified by resident physicians in labour ward in accordance with the abovementioned criteria. The wom.