INDIRECT CAUSES OF MATERNAL MORTALITY

Objective. To study maternal deaths from indirect causes to elaborate measures to prevent maternal losses. Material and methods. The statistic data of the Federal State Statistics Service of Russia and those of the Ministry of Health and Social Development of Russia, information (explanatory notes of the principal obstetricians and gynecologists of the subjects of the Russian Federation to their sectoral annual reports according to Form No. 32 «Information on medical care to pregnant women, parturients, and puerperas»), report cards on maternal deaths per 101 maternal fatal outcomes from indirect causes in 2010 were analyzed. Methods for retrospective clinical and statistical analysis and those of examination of the quality of medical care were used. Results. Indirect causes, among which diseases of circulatory (35.6%), respiratory (27.7%), and digestive (8.9%) systems are prominent, have a lead in the pattern of causes of maternal deaths. The percent of urban and rural mothers who had died from indirect causes was 67.3 and 32.7%, respectively. The proportion of premature births (at 28 weeks) was in more than half (56.3%) of the study group women with a population frequency of 3.7%; that of cesarean section was 66.7 and 21.0, respectively. The proportion of deceased women was 19.8% in first-level obstetric care facilities, 27.7% in municipal facilities, 45.6% in regional ones, and 6.9% at home. Conclusion. Among the indirect causes of death, 88 (87.1%) were listed as medical indications for artif icial termination of pregnancy. If contraceptive devices had been timely chosen for women with severe extragenital diseases in the antenatal clinics and, in the occurrence of pregnancy, its termination had been decided, 68 (67.3) fatal outcomes would have been prevented.

maternal mortality, extragenital diseases, indirect causes of death, pattern of causes