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Hypothesis/aims of study. During pregnancy, hypercoagulation develops and fibrinolysis is inhibited. These changes are particularly pronounced in pregnancy complicated by preeclampsia. The existing techniques to evaluate hemostasis are rather laborious and do not provide a complete information of the volume and density of the fibrin clot. We aimed to conduct comparative studies of the state of the hemostasis system by conventional test-tube and thrombodynamic methods in healthy non-pregnant women and in pregnant women who are suffering and are not suffering from preeclampsia. Study design, materials, and methods. We examined 40 pregnant women aged 17–33 years (mean age 24.3 ± 3.2 years) at the gestational age of 35–39 weeks. In 18 women, pregnancy was complicated by preeclampsia. The control group consisted of 35 healthy women (mean age 25.1 ± 2.6 years). The thrombodynamic characteristics of the clot were evaluated using the T-2 Thrombodynamics Recorder device (GemaKor Ltd., Russia) using the following parameters: Tlag, clot growth delay; Vi, initial growth rate; Vs, steady growth rate; D, clot density; C30, the size of the main clot in the 30th minute. Results. When evaluating the hemostasis system by the thrombodynamic method in healthy pregnant women and in women with preeclampsia compared with non-pregnant women, the onset time of clot formation was significantly reduced, the initial and steady rate of the clot appearance, as well as the clot density and the clot size being increased. Conclusion. The method for evaluating thrombodynamic properties of the blood clot is objective and visual way to estimate hemostasis. It complements the coagulogram indices and gives a clear view of the hemostasis system.

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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.