The results of a confidential audit of maternal mortality due to preeclampsia and eclampsia in Russia in 2017-2018

Aim. To identify the contemporary features of the development and progression of the most severe forms of PE and its complications, specify medical errors and management flaws in obstetric care associated with maternai deaths (both in the outpatient and hospital settings), and conduct the next stage of the confidential audit of maternai mortality due to PE and eclampsia in the regions of the Russian Federation in 2017-2018. Materials and methods. The audit was based on a retrospective analysis of primary medical documentation of 25 cases of maternai deaths from preeclampsia, eclampsia, and their complications in 2017-2018 in the Russian Federation. The data sources included outpatient medical records, maternity records, protocols of clinical examinations, inpatient medical records, and anatomic pathology reports. The documentation was provided by the Department of Child’s Care and Maternity Services of Minzdrav of Russia. Results. In 2017, according to Minzdrav of Russia, 80.9% of maternal deaths were avoidable (preventable and amenable). Analysis of our findings and literature showed that main complications of PE and eclampsia accounting for the majority of maternal deaths included cerebral edema with brainstem dislocation, multiple organ failure, massive coagulopathic hemorrhage, and, most notably, increasing incidence of stroke. We also report the most common medical errors and management flaws in obstetric care during pregnancy, delivery, and postpartum associated with maternal deaths. Conclusion. A thorough analysis of all cases of maternal deaths made it possible to formulate and substantiate several recommendations aimed at reducing maternal mortality due to PE, eclampsia, and their complications.

preeclampsia, eclampsia, maternal mortality