The role of extragenital infectious pathology in the structure of maternal mortality in Moscow

Abstract

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

Extragenital noninfectious pathology in the maternal mortality structure in Moscow

“…При незначительных ежегодных колебаниях среди нозологических причин МС в России экстрагенитальные заболевания несколько уступают прямым акушерским причинам смерти, причем значимое место в структуре причин материнской смертности в Москве играют инфекционные заболевания, в первую очередь ВИЧинфекция [4,5].…”