Critical obstetric conditions during pandemic (COVID-19) and pre-pandemic years

Author:

Belokrinitskaya T. E.1ORCID,Iozefson S. A.1ORCID,Frolova N. I.1ORCID,Brum O. Yu.2ORCID

Affiliation:

1. Chita State Medical Academy

2. Transbaikal Regional Perinatal Centre

Abstract

Aim. To assess the structure of critical obstetric conditions and maternal mortality in Transbaikal Region in pandemic (COVID-19) and pre-pandemic years (2020 and 2019, respectively).Materials and Methods. We retrospectively analysed “near miss” (NM) and maternal deaths (MD) in 2019 and 2020, further calculating the severe maternal outcome ratio (SMOR), the summary indicator which includes both NM and MD per 1000 live births.Results. In a pandemic year (2020), we observed an increase in SMOR in comparison with a pre-pandemic year (3.0 vs 2.0, respectively). In 2019, maternal mortality was exclusively caused by obstetric complications, while extragenital pathology (cardiovascular disease and COVID-19) was responsible for that in 2020. However, the main causes of «near miss» in 2019 and 2020 were similar, including obstetric haemorrhage because of placental abruption and severe pre-eclampsia. Maternal near-miss mortality ratio (MNM/MD) increased from 7.3: 1 in 2019 to 11.3: 1 in 2020, and mortality index (MD/(MNM + MD) × 100) reduced from 12.0 to 8.1. Therefore, fewer women with life-threatening conditions died in 2020 as compared with 2019, indicating a better quality of obstetric care.Conclusion. Analysis of the critical obstetric conditions can probably find regional issues of maternal healthcare during the COVID-19 pandemic and propel the policy makers to find additional resources to minimise maternal morbidity and mortality.

Publisher

Kemerovo State Medical University

Reference11 articles.

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2. Methodological approaches to the assessment and analysis of critical conditions (near miss) based on WHO criteria. Letter No. 15- 4/383 of the Ministry of Health of the Russian Federation dated March 11, 2021. (In Russ). Available at: http://zkpc-chita.ru/wp-content/uploads/2021/08/Pismo-MZ-RF_KAS_near_miss_11.03.2021.pdf. Accessed: 15 August, 2021.

3. World Health Organization. Targets and strategies for ending preventable maternal mortality. Consensus statement. World Health Organization, Geneva; 2014. Available at: https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/consensus-statement/en/. Accessed: 23 July, 2021.

4. World Health Organization. Strategies toward ending preventable maternal mortality (EPMM). World Health Organization, Geneva; 2015. Available at: https://www.who.int/docs/default-source/mca-documents/advisory-groups/quality-of-care/strategies-toward-ending-preventable-maternal-mortality-(epmm).pdf?sfvrsn=a31dedb6_2. Accessed: 23 July, 2021.

5. World Health Organization. Conducting a maternal near-miss case reviewcycle at hospital level : Manual with practical tools. WHO Regional Office for Europe; 2016. Available at: https://www.euro.who.int/__data/assets/pdf_file/0003/324390/NMCR-manual-en.pdf. Accessed: 23 July, 2021.

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