N.N. Bushmelåva
State Medical Academy of the city of Izhevsk, city of Izhevsk
Summary. Maternal mortality includes deaths associated with
pregnancy (regardless of the pregnancy term and localization) that took
place during pregnancy, delivery or within 42 days after termination of
pregnancy. Maternal mortality is one of the important criteria of social
and economic well-being of the society because it reflects access to
and quality of medical care at population reproduction.
The aim of the study is to analyze quality of medical care delivery in cases of maternal mortality in the Udmurtian Republic.
Methods and data. Expert evaluation of quality and
defects in medical care delivery, dynamics and death causes’ structure
of 134 maternal deaths in the Udmurtian Republic was based on
statistical reports, expert reports on cases of maternal deaths
(statistical form #003/u-MS), protocols of case conferences in the
Ministry of Health of the Udmurtian Republic – with due regard not only
to primary death cause but also concurrent diseases and comorbidities as
well as dominating clinical symptom complex which lead to lethal
outcome or contributed to it.
Results. Quality evaluation of medical care delivery in
cases of maternal deaths identified certain defects at different stages
of care delivery: defects were found in 67.5% of cases at the
outpatient level; in 64.9% of cases at the inpatient level and in 41.7%
of cases during resuscitation activities.
Frequency analysis of treatment, diagnostic, organizational and
patient management defects in cases of maternal deaths at medical
facilities of different levels of care delivery featured organizational
and patient management defects as being most important defects at
primary and secondary level of care delivery.
The defects’ analysis also serve as a basis for developing ways to
optimize medical and organizational approaches towards improved care
delivery to women aimed at reducing reproductive loss at all stages of
care delivery.
The results obtained were incorporated in the differentiated approach to develop measures aimed at reduced maternal mortality.
Keywords: reproductive loss; maternal mortality; somatic and reproductive health of women; defects in medical care delivery.
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