Analysis of obstetric «near miss» cases in the Ryazan region

Abstract

Although maternal mortality cases in Russia have become rare, the problem of their prevention remains relevant. To enforce the preventive measures, an analysis of critical conditions and «near miss» cases in obstetrics is commonly used. As a result, the quality of medical care in obstetric institutions improves. Aim: to assess the character and incidence of critical situations in obstetrics practice over the Ryazan region in 2015-2017 and to analyze the failures in medical care that led to such situations. Materials and methods. We analyzed 46 «near miss» cases and 1 case of maternal death recorded in the Ryazan region in 2015-2017. Results. The leading cause of critical conditions in obstetrics found in the Ryazan region was hemorrhage following an emergency caesarean section delivery. In most cases, bleeding was caused by pregnancy complications, although extragenital conditions also contributed to the development of the «near miss» situations. The main indication for emergency delivery was the premature detachment of a normally located placenta; in the normal term delivery, it was an inconsistent uterine scar after cesarean section and the accompanying pathology, such as placenta accreta. Conclusion. Considering the «near miss» cases as a separate group of obstetrics conditions contributes to the prevention of maternal mortality and improves the healthcare standards in obstetric institutions.