Obstetric Hemorrhages as the Main Cause of Critical Conditions and Maternal Mortality

Aim. To identify measures for the improvement of obstetric techniques and telemedicine technologies in women with major obstetric haemorrhage.Materials and Methods. We analyzed medical documentation of 54 women in Altai Krai who experienced major obstetric haemorrhage within 28- 36 weeks of gestation before (2008-2012) and after (2013-2017) implementation of risk management using the telemedicine “Registry of pregnancies” technology.Results. Implementation of risk management principles led to the admission of women with major obstetric haemorrhage exclusively to specialised hospitals in contrast to the preceding period. Further, it was associated with a higher prevalence of caesarean sections (from 55.6% to 96.3%) in women with major obstetric haemorrhage due to an increase in cases of complete placenta previa or placenta increta. In 73.0% of cases, such patients delivered in specialised hospitals where autologous blood transfusion or intrauterine balloon tamponade could be applied. In spite of increase in frequency of major obstetric haemorrhages, risk management reduced their severity by decreasing blood loss and, hence, the risk of posthaemorrhagic complications and blood transfusion side effects.Conclusions. Risk management-based strategy for optimising obstetric care by telemedicine technologies leads to the admission of high-risk, even “near miss” patients in specialised hospitals that is particularly efficient in regions with low population density and a large network of primary healthcare facilities.

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Features of Diagnosis and Treatment of Obstetric Bleeding, Accompanied by Coagulopathy

Камилова¹,

Perinatology²,

Aminzoda³

2020

Avi Bull

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The literature of recent years on modern methods of diagnosing and treating coagulation disorders in obstetric bleeding (OB) were studied and analyzed. The literature is presented on the frequency and structure of OB in the world and countries with different levels of development. It has been shown that massive OB is often accompanied by impaired blood clotting and lead to maternal mortality. In the structure of causes of maternal mortality in the world, OB is in the leading position. A theoretical and critical analysis of the literature on modern methods of diagnosing and treating coagulation disorders in OB has shown that it is necessary to continue further research on optimization of diagnostics and individual approaches in infusion-transfusion therapy of women with massive OB. Optimization of the methods of diagnosis and treatment of OB will improve obstetric outcomes in this complication. Keywords: Obstetric bleeding, maternal mortality, coagulopathy, diagnostics, treatment

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Obstetric Hemorrhages as the Main Cause of Critical Conditions and Maternal Mortality

Cited by 3 publications

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Experience in using metroplasty using distal compression hemostasis for organ-preserving surgery at placenta accreta

Experience in using metroplasty using distal compression hemostasis for organ-preserving surgery at placenta accreta

Major obstetric haemorrhage: portrait of "near miss" and risk management-based optimisation of obstetric techniques and telemedicine technologies

Features of Diagnosis and Treatment of Obstetric Bleeding, Accompanied by Coagulopathy

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