Maternal mortality

• Devyatova E.A.

Abstract

Objective. Although maternal mortality index has clearly decreased according to WHO data, the target index is not achieved yet. Unsafe abortion accounts 13 % of maternal mortality worldwide. Being a citizen of developing country one during life lime has the risk of maternal morbidity and mortality 36 times higher. 5 million women are admitted to hospital with complications of unsafe abortion. Amniotic fluid embolism is leading reason of maternal mortality in developed countries. According to recent data its incidence varies from 1:12 953 deliveries in the USA to 1:16 393 deliveries in Australia. Low level usage of science-based research at point time of clinical decision, formulation of health policy and system approach may affect maternal mortality index negatively. Contemporary maternal health research cannot adequately reflect the differences of maternal mortality index in different categories of reproductive-aged women, especially in conditions of restricted medical resources. The lack of investigations and their low application in health policies play definitely negative role.

Aim: 1) to identify research gaps in maternal health investigations and prioritize the area for future scientific research to lead to reduction of maternal mortality; 2) to form the sharpest questions for future research of maternal health; 3) to range the research needs aimed at profit of usage for various resources for decreasing maternal mortality index.

Results. Review forms the main questions for future science-based research priorities in maternal health problem: postpartum hemorrhage, abortion, hypertensive disorders, infections/sepsis, caesarean section, diabetes mellitus, pregnancy preservation, preterm delivery, other reasons and health policies including health services.

Conclusion. We identified factors (patients’ personal characteristics, health facilities, health policy) which are connected with complicated abortion and influence at maternal morbidity and mortality index strongly: unwanted pregnancy, unsafe abortion, poor health services, safe abortion unavailability. Usage of science-based research makes the detection of the investigation gaps in maternal health issue available. This new approach can be helpful in choosing priorities for future scientific research of health policy and may become especially valuable for health services in developing countries and in the state of restricted resources.

Keywords:maternal health, maternal morbidity, maternal mortality, Cochrane collaboration, review, health priority.

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