T.E. BELOKRINITSKAYA, N.I. FROLOVA, S.A. IOZEFSON, K.A. KOLMAKOVA

 Chita State Medical Academy, Chita

  Contact details:

Belokrinitskaya T.E. ― MD, Professor, Head of the Obstetrics and Gynecology Department

Address: 39a Gorkiy Str., 672000, Chita, e­-mail: tanbell24@mail.ru

 Objective. To assess the structure of critical obstetric states and maternal mortality in patients depending on the age group of patients.

Material and methods. A retrospective analysis of 112 “near miss” cases and 20 maternal mortality cases in Transbaikal region during a 5-year period (2014-2018).

Results. The young reproductive age group consisted of 102 (77.3%) women aged 18-35, the late reproductive age group consisted of 30 (22.7%, p=0.000) women over 35 y.o. Women of young reproductive age had 80.4% (p=0.000) “near miss” cases and 60.0% (p=0.008) maternal mortality cases. Patients of young reproductive age had a higher risk of critical states due to placental abruption (OR=4.21), placenta previa and/or placenta accreta (OR=2.41), preeclampsia/eclampsia (OR=1.21) and the significant risk of postpartum hemorrhage (p=0.040). Women of late reproductive age more often had extragenital diseases (30.0% vs 4.9%; p=0.000), ectopic pregnancy (6.7% vs 2.9%; OR=2.35) and complications after out-of-hospital and medical abortions (20.0% vs 2.7%; OR=1.71).

Conclusion. Systematic analysis of the age structure of “near miss” and maternal mortality cases may yield additional resources to reduce maternal mortality and morbidity.

Key words: near miss; maternal mortality; young and late reproductive age.

(For citation: Belokrinitskaya T.E., Frolova N.I., Iozefson S.A., Kolmakova K.A. Structure of critical obstetric states and maternal mortality in patients of young and late reproductive age. Practical medicine. 2019. Vol. 17, № 4, P. 32-36)

REFERENCES

1. Strategies toward ending preventable maternal mortality (EPMM). World Health Organization, Geneva, 2015, available at: https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/epmm-references/en/ (accessed on: 10 July, 2019)
2. Targets and strategies for ending preventable maternal mortality. Consensus statement. World Health Organization, Geneva, 2014, available at: https://apps.who.int/iris/bitstream/handle/10665/130776/WHO_RHR_14.21_eng.pdf?sequence=1 (accessed on: 10 July, 2019)
3. Vnedrenie tsikla Analiza Kriticheskikh Sluchaev v akusherskoy praktike na urovne statsionara [Implementation of the Critical Cases Analysis cycle in obstetric practice at the hospital level]. Posobie i prakticheskie instrumenty. Vsemirnaya organizatsiya zdravookhraneniya, 2016. 104 p.
4. Pattinson R. Near miss audit in obstetrics. Best Pract. Res. Clin. Obstet. Gynaec, 2009, vol. 23, no. 3, pp. 285-286.
5. Rossiyskiy statisticheskiy ezhegodnik. 2018: Stat.sb./Rosstat [Russian statistical yearbook. 2018: Stat.sb. Rosstat]. Moscow, 2018. 694 p.
6. Belokrinitskaya T.E., Iozefson S.A., Liga V.F., Anokhova L.I., Audit of “near miss” cases in the Trans-Baikal Territory in 2014. ENI Zabaykal’skiy meditsinskiy vestnik, 2015, no. 2, pp. 137-141 (in Russ.).
7. Lebedenko E.Yu., Radzinskiy V.E. Near miss. Na grani materinskikh poter’ [Near miss. On the verge of maternal losses]. Moscow: Izd-vo zhurnala “StatusPraesens”, 2015. 184 p.
8. Say L., Souza J.P., Pattinson R.C. WHO working group on Maternal Mortality and Morbidity classifications. Maternal near miss — Towards a standard tool for monitoring quality of maternal health care. Best Pract. Res. Clin. Obstet. Gynaecol, 2009, no. 23, pp. 287-296.
9. Souza J.P., Gülmezoglu A.M., Lumbiganon P., Qureshi Z. and WHOMCS Research Group. The World Health Organization Multicountry Survey on Maternal and Newborn Health: study methods. BMC Health Services Research, 2011, no. 11, p. 286.