About this Journal Publication ethics Editorial Board Editorial Council Editorial Office For the Authors Contacts

News feeds

Journal in Databases

eLIBRARY.RU - ═└ËÎ═└▀ Ţ╦┼╩Ďđ╬══└▀ ┴╚┴╦╚╬Ď┼╩└

Google Scholar

Google Scholar

Main arrow Archive of previous Issues arrow ╣3 2014 (37) arrow Defects in medical care delivery in cases of maternal death at the regional level
Defects in medical care delivery in cases of maternal death at the regional level Print
Tuesday, 15 July 2014

N.N. Bushmelňva
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 causesĺ 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 ľ 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 defectsĺ 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.


  1. Aleksandrova O.Yu., Gerasimenko N.F., Grigor'ev Yu.I., Grigor'ev I.K. Responsibility for offenses in medicine: Training manual for high school students. Moscow: Akademiya; 2006. 240 p. (In Russian).
  2. Analysis of causes for maternity mortality: Manual for physicians. A.P. Milovanov, editor. Moscow: Meditsina dlya vsekh; 2008. 228 p. (In Russian).
  3. Gulyaev V.A., Semkin L.B., Filatov V.V. Methodical basis for an analysis of defects in medical care provision. Voenno-meditsinskiy zhurnal 2001; (4): 15 - 20. (In Russian).
  4. Zhumanazarov N.A. Characteristics of defects in providing medical care to pregnant women, birthing mothers, and children. Sibirskiy meditsinskiy zhurnal 2009; (4): 145-146. (In Russian).
  5. Kulakov V.I., Serov V.N., Sharapova O.V., Kira E.ď. The ethical and legal aspects of obstetric care in the present day Russia. Akusherstvo i ginekologiya 2005; (5): 3-8. (In Russian).
  6. Luzanova I.M. Improper medical care provision in obstetric practice (health and legal aspects of the problem). Cand.Med.Sci [thesis]. Moscow. 2007. 25 p. (In Russian).
  7. Sklyar M.S. Reorganization of the regional service for maternity and child health protection on the base of strategic planning. Moscow: Federal Research Institute for Health Organization and Informatics of the MoH of the RF; 2008. 192 p. (In Russian).
  8. Ogarkov I.F. Physician offences and criminal responsibility for them. Leningrad: Meditsina. 1966. 196 p. (In Russian).
  9. Pogorelova E.I. Scientific grounds for the system of measures for increasing the reliability of population mortality statistics. Cand.Med.Sci [thesis]. Moscow. 2004. 24 p. (In Russian).
  10. Starodubov V.I., Sukhanova L.P. Reproductive problems in demographic development of Russia. Moscow: źMenedzher zdravookhraneniya╗; 2012. 320 p. (In Russian).
  11. Starchenko A.A., O.V. Tarasova, O.V. Saldueva. Defects classification in the MHI system in providing care for obstetric hemorrhage. ôReproductive problemsö Special issue. Moscow. 2012. P. 20-21. (In Russian).
  12. Starchenko A.A Standards for assessing the quality of medical care. [Internet] [cited 2014 May 28]. Available from: http://www.nacmedpalata.ru/?action=show&id=10975 (in Russian).
  13. Stetsenko S.G. Medical Law: Textbook. St. Petersburg. 2004. 234 p. (In Russian).
  14. Tomilin V.V., Sosedko Yu.I. Rationale for the basic concepts of defects in medical care provision. Sudebno-meditsinskaya ekspertiza 2000; (6): 4-8. (In Russian).
  15. Chavpetsov V.F., Perepech N.B., Mikhaylov S.M., et al. The bases of expertise of medical care quality and automated technology for its assessment; Methodic Manual. St. Petersburg. MHI Federal Fund.1994. 42 p. (In Russian).
  16. Shchepin O.P., Starodubov V.I., Lindenbraten A.L., Galanova G.I. Methodical grounds and mechanisms for providing high quality medical care. Moscow: Meditsina; 2002. 176 p. (In Russian).
  17. Hagglin R. Differential diagnosis of internal diseases. [Transl. from English]. E.M. Tareev, editor. Moscow: Triada-Kh; 1997. 794 p. (In Russian).
  18. Joffe M,. Paranjothy Sh, Fielder H. et al. Use of time to pregnancy in environmental epidemiology and surveillance. Journal of Public Health 2008: 30 (2): 178.

Views: 17476

Be first to comment this article

Write Comment
  • Please keep the topic of messages relevant to the subject of the article.
  • Personal verbal attacks will be deleted.
  • Please don't use comments to plug your web site. Such material will be removed.
  • Just ensure to *Refresh* your browser for a new security code to be displayed prior to clicking on the 'Send' button.
  • Keep in mind that the above process only applies if you simply entered the wrong security code.

Code:* Code

Last Updated ( Tuesday, 15 July 2014 )
< Prev   Next >
home contact search contact search