Introduction. Diseases that are not directly related to obstetric pathology and childbirth fade into the back-ground and are not always included in the maternal mortality, but their significance can hardly be overes-timated. A special group of such pathologies comprises infectious diseases, the prevalence of which varies significantly in different countries. As a rule, these diseases are characterized by a severe course and are life-threatening for the mother and the child. The most relevant among them are HIV infection, tuberculosis, infectious endocarditis, and sepsis. The aim of the study was to consider the leading extragenital causes of maternal mortality and to assess the importance of infectious pathology based on the pathological findings. Materials and methods. The study included 38 pathological autopsies, 10 of which are described in more detail. Medical documentation, autopsy protocols for deceased pregnant women, women in labor, and women in childbirth were examined. Causes of death were classified according to the ICD-10 criteria. A clinical and morphological study was carried out, and supportive laboratory techniques were used (microbiological, histobacterioscopic, molecular genetic, serological, and cytological tests). Results. As it follows from the autopsy report data from 2013 to 2019 in Moscow, the extragenital pathology accounted for 38 lethal cases (46.9% of all maternal deaths), of which 10 (26.3%) cases were associated with infectious pathology. Conclusion. Extragenital pathology, although not a leading cause of maternal mortality, remains a crucial obstetric problem. Infectious diseases, primarily HIV infection, are the significant cause of extragenital morbidity. Keywords: maternal mortality, extragenital infectious pathology, tuberculosis, HIV infection, infectious endocarditis, drug addiction, Kaposi’s sarcoma

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Objective. To study the main causes of maternal mortality and to determine the role of obstetrical pathologies based on the findings of pathoanatomical autopsies. Materials and methods. The study included 42 autopsy findings, we studied medical documentation, autopsy records of deceased pregnant and parturient women. The most common causes of mortality (n = 29), according to the latest revision of ICD-10, were analyzed in detail. The general clinical and morphological examination was performed. Results. In Moscow, more than half of cases in the structure of maternal mortality refer to obstetrical pathologies. The most significant role belongs to preeclampsia and eclampsia (28.6%), they are in most cases characterised by an atypical clinical course and a specific pathomorphological picture. The second place is taken by massive pulmonary embolism (9.5%), the third place belongs to maternal shock during labour (7%) and the fourth place is shared by intrapartum infection (obstetrical sepsis), complications associated with obstetrical operative intervention and procedures, postpartum cerebral venous thrombosis, amniotic fluid embolism, postpartum cardiomyopathy (4.8%). Conclusion. The leading position in the structure of maternal mortality due to obstetrical causes belongs to preeclampsia and eclampsia. This pathology requires a complex approach to diagnosis and treatment, and postmortem verification of diagnosis should be confirmed by morphological examination with the use of immunohistochemical reactions. Key words: maternal mortality, obstetric pathology, preeclampsia and eclampsia, pulmonary embolism, maternal shock, obstetrical sepsis

Introduction. Diseases directly related to pregnancy are still leading the maternеal mortality structure, al-though in many countries there is an increase in the number of deaths from extragenital pathology among pregnant women. A significant number of lethal cases in this group are associated with environmental factors, lifestyle, and the overall increase in somatic diseases. The aim of the study was to determine the main causes of maternal mortality and investigate the role of extragenital pathology based on autopsy data. Materials and methods. The study included 29 autopsy observations. We studied medical records, autopsy protocols of deceased pregnant women, women in labor, and puerperant women. Each cause of death was classified according to ICD-10. A clinical and morphological study was also carried out using additional histochemical and immunohistochemical staining methods. Results. The data from pathological studies show that in Moscow, extragenital pathology accounts for up to 40% of maternal deaths. The leading cause of death is circulatory system diseases, including an arteriovenous malformation; a myocardial infarction; a congenital heart disease (patent foramen ovale); cerebral, aortic, and splenic artery aneurysms. The second most common one is other specified diseases and conditions com-plicating pregnancy. This group of diseases included malignant neoplasms. Less common causes of death are gastrointestinal diseases, other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism that complicate pregnancy, and also respiratory diseases. A single case is associated with a generalized viral infection. Conclusion. Extragenital pathology remains an important obstetric problem, and the management of pregnant women with systemic diseases requires a multidisciplinary treatment approach. Keywords: maternal mortality, extragenital pathology, arteriovenous malformation, cerebral aneurysm, antiphospholipid syndrome