Obstetric Hemorrhage Is as One of the Causes of Maternal Deaths

Abstract

Obstetric hemorrhage as a cause of maternal morbidity and mortality, over a long period it is one of the leading places in the world and among the five major causes of maternal mortality (MM). We aimed to analyze the reasons for MM in obstetric hemorrhage and to determine the complex of measures on prevention of maternal mortality from obstetric hemorrhage. Clinical, 45retrospective clinical and statistical analysis of data were studied in 67 stories of births ended in maternal mortality from obstetric hemorrhage. The dead women were aged 20-29 years-38 (57%), 30-35 -19 (28%), over 36 -10 (15%). By parity of predominated over repeatedly pregnant. The first pregnancy was 23 (34.3%), repeatedly pregnancy -25 (37.3%) and multiple pregnant women -19 (28.4%). Causes of bleeding were placenta abruption -in 31 (46%), placenta previa in 2(3%), Hypo -or atonic bleeding in 24 (36%), injuries of the birth canal -in 6(9%), intra-abdominal vascular bleeding -2 (3%), coagulopathies bleeding -in 1 (1.5%) women. Bleeding due to an ectopic pregnancy in 1 (1.5%). Bleeding in the late postpartum period occurred in 5 (8%) women. Bleeding is diagnosed late in 4 due to the fact that in 3 cases, the women were not observed after birth (14%) and in 1 case (1.5%) -after the surgery. The most frequent omissions and unrecorded features were late admission to hospital in the state of hemorrhagic shock in 40%. Late deliveries were in 31%; delayed cesarean section were in 27%; bleeding after cesarean section was in 25%; wrong choice of surgery volume in 22%; underestimation of blood loss in 52%; non-compliance with protocols in 54%, non-surgical method for stopping bleeding was 12%, not the source of bleeding was 6%. These data indicate the need to improve emergency care in maternity institutions. We can deduce the following recommendations for the prevention of mortality from hemorrhage: improvement of antenatal care and the treatment of pregnant women of groups with risk factors for bleeding, in the first place, suffering extragenital diseases and training of obstetricians and gynecologists.