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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