The results of the systematization of reasons for obstetric bleeding and preeclampsia near-miss opportunities established during an audit in 20 delivery homes in Tajikistan are presented in this article. The following reasons were reported: knowledge (45%), organizational problems (38%), and necessity for the correction of National Standards of obstetric bleeding and preeclampsia (13%). Therefore, determining recommendations for this country is a practical step to realize “near-miss” opportunities to prevent obstetric bleeding and preeclampsia.
Background. The investigation, holding estimations methods quality aid for mothers introduction, isactuality, because have the practical importance.
Aim – to estimate the “near-miss” obstetric bleeding and preeclampsia imp lamination methods.
Materials and methods. The estimation testing results before and after study seminar and hole estimations of practice using “near-miss» obstetric bleeding and preeclampsia.
Results. The study of “near-miss” principles with using interactive methodology is effectively. The monitoring with using hole estimations of practice using “near-miss” help find severe and poorly sides.
Conclusion. Interactive study of “near-miss” principles and methodology with following monitoring help to successful imp lamination this instrument in practices delivery homes.
Study Objective: To compare the rates and causes of stillbirth in level 2 and 3 obstetric institutions. Study Design: This was a retrospective group study. Materials and Methods: Statistical data and labor and delivery histories of women who experienced stillbirth and were admitted to obstetric facilities (two level 2 facilities and one level 3 facility) between January and June 2019 were reviewed. Retrospective analysis was done of their labor and delivery histories, and the cases of stillbirth were clinically analyzed, using the ReCoDe classification. Study Results: The frequency of stillbirth was higher in the level 3 hospital. Irrespective of the level of hospital, mortality in the antenatal period dominated (four out of six cases in the level 2 facilities and 104 out of 129 in the level 3 facility); it was more often due to congenital malformations in the level 2 facilities and to intrauterine growth restriction (IUGR) or placental insufficiency in the level 3 facility. In the level 3 hospital, the most common causes of intranatal fetal death included maternal (pre-eclampsia and extragenital diseases) and fetal (IUGR) disorders that developed before labor. The risk factors for stillbirth were inadequate quality of medical services and factors related to the woman or family, such as late registration for prenatal care, non-compliance with doctors’ recommendations, etc. Conclusion: The actual causes, as established in this study, of negligence leading to stillbirth demonstrate that there is potential for reducing perinatal mortality. Keywords: stillbirth, antenatal and intranatal fetal death, ReCoDe classification, causes of stillbirth, perinatal audit.
The article reviews the use of maternal near-miss in maternity hospitals of Tajikistan and its effect on selected indicatior of maternal bleedings. The implementation of standards and the use of near miss case review in 20 maternity hospitals was shown to decrease the rate of maternal bleedings, especially hypotonic bleedings, the rate of critical hypotonic bleedings, the rate of hysterectomy, and the ratio between deaths due to maternal bleeding in these maternity hospitals and overall maternal bleeding mortality. Our results confirm, that the use of “near-miss” strategy improves the quality of maternal medical care and allows to decrease overall maternal mortality.
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