Current issues in preeclampsia: a ten-year analysis of maternal mortality


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Abstract

Aim. To investigate the implementation of evidence-based guidelines for the prevention of adverse outcomes in preeclampsia. Materials and methods. The study analyzed medical records of 129 maternal deaths from preeclampsia/eclampsia and their complications in Russia's regions from 2010 to 2019. Data for years 2010-2015 (n=63) were compared with that for 2016-2019 (n=66). Between these periods, all Russian Federation regions adopted new terminology, classification, and management strategy for preeclampsia established by new national guidelines. Results. In 2010-2015 amenable and preventable maternal preeclampsia-related mortality reached 89%. There were significant medical errors in patients' management related to inappropriate prevention and treatment in outpatient and inpatient settings. The introduction of new national guidelines for preeclampsia management resulted in improved maternal and perinatal outcomes and sharply reduced amenable and preventable maternal mortality. Conclusion. Standardization, strict adherence to approved protocols, and continuous maternal health care quality assessment is an effective and promising way to reduce preeclampsia-related maternal mortality.

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About the authors

Iraida S. Sidorova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: sidorovais@yandex.ru
Dr. Med. Sci., Professor, Academician of the RAS, Merited Scholar of the Russian Federation, Department of Obstetrics and Gynecology № 1, N.V. Sklifosovsky Institute of Clinical Medicine

Natalya A. Nikitina

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: natnikitina@list.ru
Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology № 1, N.V. Sklifosovsky Institute of Clinical Medicine

Oleg S. Filippov

Department of Child's Health Care and Maternity Services, Ministry of Health of Russia

Dr. Med. Sci., Professor, Merited Doctor of the Russian Federation, Deputy Director

Yelena V. Guseva

Department of Child's Health Care and Maternity Services, Ministry of Health of Russia

Deputy Director of the Department - Head of the Department of Reproductive Health and the Implementation of Effective Obstetric and Gynecological Care

Mikhail B. Ageev

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: mikhaageev@yandex.ru
Ph.D., Teaching Assistant at the Department of Obstetrics and Gynecology №1, N.V. Sklifosovsky Institute of Clinical Medicine

Albert A. Kokin

Maternity Hospital affiliated to the V.V. Veresaev Clinical Hospital of Moscow City Health Department

Email: alberkokin@yandex.ru
Head of the Department of Anesthesiology and Intensive Care

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