Effectiveness of prevention and early diagnosis of critical obstetric conditions in preeclampsia as a factor in reducing maternal and infant morbidity and mortality

• Elena N. Vasilkovskaya
• Anzhelika Е. Kasparova
• Larisa A. Chegus
• Anzhelika T. Pachaeva
• Alexey I. Pakhtusov

Abstract

The aim of the study was to assess the effectiveness of prevention and early diagnosis of critical obstetric conditions (COC) during preeclampsia in reducing maternal and infant morbidity and mortality in the perinatal center of the Western medical zone in the Khanty-Mansiysk Autonomous Region – Yugra.

Material and methods. A total of 132 pregnancy histories and outcomes of women with PE delivered in the budgetary institution Khanty-Mansiysk District Clinical Hospital, Khanty-Mansiysk city, were analyzed by the solid sampling method. Inclusion criteria for the study: all cases of COC caused by PE and its complications for the periods 2010–2011 (n=58) and 2019–2020 (n=74).

Results. According to the register of critical obstetric conditions in the Khanty-Mansiysk Autonomous Region – Yugra in 2022, patients with preeclampsia accounted for more than half of the cases, which is 2.4 times higher than in 2021. Due to the classification of pregnant women with PE into the group of COC, in 2019–2020, 77.0% of pregnant women were consulted in the perinatal center of the RCH, in 2010–2011 – only 3.4% (p_2–3=0.000) – increase in the number of consultations by 22.6 times, an increase in antenatal hospitalizations was also noted – 70.7 vs 96.7% (p_2–3=0.000). After the patients were referred for hospitalization to the Perinatal Center of the Regional Clinical Hospital of the city of Khanty-Mansiysk and additional examination was carried out, in 20.7 and 52.7% of pregnant women the diagnosis was changed to PE (moderate and severe). The term of delivery in the groups of patients with PE was 34.3 (32.0–38.0) and 35.0 (33.4–38.0) in 2010–2011 and 2019–2020 respectively (p_2–3>0.05).

Keywords:preeclampsia; maternal mortality; specialized vertically integrated medical information system

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