CAUSES OF MATERNAL MORTALITY FROM PREECLAMPSIA AND ECLAMPSIA IN RUSSIA IN 2013

Objective. To study the therapeutic and diagnostic tactics for the management of pregnant women, parturients, and puerperas who have died from the severe forms of preeclampsia, eclampsia, and their complications in Russia in 2013. Subjects and methods. Thirty-four blind copies of primary medical records (outpatient cards, pregnant woman’s cards, puerpera’s cards, labor histories, inpatient’s cards, postmortem examination protocols) for the 2013 maternal deaths from preeclampsia and eclampsia were retrospectively analyzed. Results. Maternal mortality from severe preeclampsia and eclampsia was more frequently associated with the development of multiple organ dysfunction, brain edema, acute disseminated intravascular coagulation and massive hemorrhage, septic complications, and extragenital comorbidities. The physicians’ most common errors continue to be underestimation of the severity of disease and untimely labor and delivery in the presence of atypical severe preeclampsia (critical hypertension (^ 180/120 mm Hg) occurred in 41.7% (95% CI 24.6-59.3) of the dead, generalized edema in 64.2% (95% CI 46.5-80.3), high-grade proteinuria in 45.8% (95% CI 29.8- 64.9). At the same time, terminology, classification, and a set of laboratory and functional studies used in the majority of obstetric facilities have not virtually changed in recent years. Maternal death was preventable and arbitrarily preventable in 85.3% (95% CI 68.9-95.0). Conclusion. To reduce maternal mortality from preeclampsia/eclampsia requires universal compliance with the unified current terminology, classification, diagnostic criteria, and severity evaluation, which are approved by the ICD-10, the procedures, standards, and protocols of the Ministry of Health of the Russian Federation, the Fifth Congress of Obstetricians/Gynecologists; introduction of evidence-based scientific advances into obstetric practice.

maternal mortality, preeclampsia, eclampsia