Критические акушерские состояния в Дальневосточном федеральном округе в пандемию COVID-19 и до эпидемии

Abstract

Study Objective. To assess the structure and indicators of critical obstetric conditions and maternal deaths in the Far East Federal District of Russia before (2019) and during (2020) the COVID-19 pandemic. Study Design: Retrospective comparative analysis. Material and methods. We have reviewed medical records on near misses (NM) and maternal deaths (MD) for 2019 (194 and 17, respectively) and 2020 (207 and 19, respectively). Descriptive statistics, cross tables analysis with evaluation of the Pearson’s chi-square and p-value, odds ratio calculation at 95%CI were used for mathematic data processing. Study Results. In 2019 and 2020, maternal death rate was 18.7 and 21.1 per 100,000 live births, respectively. Obstetric causes of maternal deaths demonstrated statistically significant reduction during the COVID-19 pandemic (2020) (26.3% vs 76.5% in 2019, р < 0.05); the ratio of life-threatening conditions (NMs and MDs) grew from 2.3 to 2.5; and COC (NM) coefficient soared from 2.1 to 2.3 per 100,000 life births. Reduction in the survival index from 11.4 to 10.9 and increase in the death index from 8.1% to 8.4% can evidence poorer quality of medical care. Conclusion. Analysis of trends and indicators of the critical obstetric conditions allows evaluating the system of organisational and medical measures, revealing issues with obstetrics services and finding additional resources to reduce maternal morbidity and mortality during the emergency situation caused by COVID-19. Кeywords: critical obstetric conditions, near miss, maternal deaths, COVID-19.