Latar Belakang: Masih tingginya angka kematian ibu di Indonesia masih terbilang cukup tinggi, MMR (Maternal Mortality Rate) di Indonesia sendiri data tahun 2017 mencapai angka 177 per 100.000 kelahiran hidup. Near-miss didefinisikan sebagai ibu hamil atau ibu baru melahirkan (dalam 42 hari setelah terminasi kehamilan) yang jiwanya terancam tetapi berhasil selamat karena pelayanan atau perawatan yang baik atau karena faktor kebetulan. Kejadian near-miss atau nyaris meninggal sangat dipengaruhi oleh kualitas layanan kesehatan terutama pada masa pandemi. Pandemi COVID-19 telah menimbulkan implikasi pada berbagai sektor termasuk sektor pelayanan kesehatan maternal dan neonatal. Tujuan: Mengetahui bagaimana hubungan pandemi COVID-19 dengan kejadian near-miss atau nyaris meninggal pada pasien – pasien yang mendapatkan metode persalinan sectio caesarea di rumah sakit Ananda Bekasi periode rawat inap Oktober 2019 – Juni 2020. Metode: Penelitian observasional menggunakan desain kohort retrospektif. Data yang digunakan diambil dari rekam medis pasien – pasien obstetrik di rumah sakit tempat penelitian ini dilakukan. Analisis data dilakukan bertahap, dimulai dari analisis univariat, analisis bivariat, analisis stratifikasi dan analisis multivariat dengan cox regression untuk mengidentifikasi hubungan antar vaiabel. Hasil: Terdapat 46 kasus near-miss (10,48%) dari total sampel penelitian sebanyak 439. Pada Analisa bivariat ditemukan bahwa ibu yang mendapat tindakan sectio caesarea pada masa pandemi COVID-19 memiliki risiko sebesar 1,35 lebih besar untuk mengalami near-miss (RR 1,356 ; 95% CI 0,78 – 2,34) p value 0,272.

---

Background: The maternal mortality rate (MMR) in Indonesia remains relatively high. The Indonesia MMR data in 2017 showed that the rate of maternal mortality reached 177 per 100,000 live births. Near-miss is pregnant women or mothers who have recently given birth (within 42 days after termination of pregnancy) with threatening live conditions, but managed to survive due to health service quality or health care or due to accidental factors. Near-miss incidence or near death is greatly influenced by health service quality, especially during the COVID-19 pandemic. The COVID-19 pandemic brings implications to various sectors including the maternal and neonatal health care sector. Objectives: This study aims to find the relation between the COVID-19 pandemic and near-miss incidents or near-death in patients who received the delivery method with sectio caesarea at Ananda Hospital Bekasi, inpatient period from October 2019 to June 2020. Methods: By using a retrospective cohort design, this observatory study analyzed data taken from the medical records of obstetrical patients in some stages, starting with univariate analysis, bivariate analysis, stratification analysis, and multivariate analysis with cox regression to find relationships between variables. Result: This study shows that from the total sample of 439 patients with sectio caesarean, 46 cases are near-miss cases (10.48%). Furthermore, the bivariate analysis shows that mothers who received sectio caesarean during the COVID-19 pandemic have greater risk (1.35) of experiencing near-miss (RR 1.356; 95% CI 0.78 - 2.34) p-value 0.272.