ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Septic Complications in Obstetrics: the Point of No Return. Evaluation and Prognosis

DOI:10.31550/1727-2378-2020-19-6-7-14
For citation: Olenev A.S., Konoplyannikov A.G., Vuchenovich Yu.D., Ziyadinov A.A., Novikova V.A., Radzinsky V.E. Septic Complications in Obstetrics: the Point of No Return. Evaluation and Prognosis. Doctor.Ru. 2020; 19(6): 7–14. (in Russian) DOI: 10.31550/1727-2378-2020-19-6-7-14
23 July 14:14

Study Objective: To assess the capacities of Moscow facilities to reduce maternal mortality in obstetric patients with life-threatening septic complications.

Study Design: This was a retrospective and prospective, multicenter, cohort study.

Materials and Methods: The study was conducted at 27 Moscow medical centers. Sixty labor and delivery histories of obstetric patients with life-threatening septic complications were analyzed between 2013 and 2019, including 10 cases of maternal death (MD group) and 50 cases of near miss (NM group).

The statistical significance of differences between the groups was evaluated by the Student t-test for normally distributed data and the Mann–Whitney U-test for non-normally distributed data.

Study Results: The opportunities available in the metropolis increased the odds of NM for women with prolonged rupture of membranes (odds ratio [OR] 13.78; 95% CI: 1.59–119.29) and those at weeks 22-36 of gestation (OR 47.25; 95% DI: 5.24–426.44), and made it possible for women with preterm pregnancies to give birth to live babies (including 78.57% of women with extremely preterm pregnancies).

Conclusion: In metropolises MD is potentially preventable. Gestational risk factors for MD confirm the importance of preconception counselling, which implies prevention of a complicated course of pregnancy and exacerbation or onset of extragenital diseases.

Contributions: Dr. A.S. Olenev participated in designing the study and outlining its goal and objectives, extracted data from source medical records, selected units of observation, analyzed results, did statistical analysis, selected sources of literature, and co-authored the paper. Dr. A.G. Konoplyannikov participated in designing the study and analyzed results. Dr. Yu.D. Vuchenovich and Dr. A.A. Ziyadinov extracted data from source medical records, selected units of observation, and analyzed results. Dr. V.A. Novikova took part in formulating the working hypothesis, analyzed and interpreted results, did statistical analysis, selected sources of literature, and co-authored the paper. Dr. V.E. Radzinsky participated in designing the study and outlining its goal and objectives, as well as in formulating the working hypothesis, and approved the final version of the manuscript submitted for publication.

Conflict of interest: The authors declare that they do not have any conflict of interests.

A.S. Olenev (Corresponding author) — Peoples’ Friendship University of Russia (a Federal Government Autonomous Educational Institution of Higher Education); 6 Miklouho-Maclay St., Moscow, Russian Federation 117198. ORCID: http://orcid.org/0000-0001-9632-6731. E-mail: olenevAS@zdrav.mos.ru

A.G. Konoplyannikov — N.I. Pirogov Russian National Research Medical University (a Federal Government Autonomous Educational Institution of Higher Education), Russian Federation Ministry of Health; 1 Ostrovityanov St., Moscow, Russian Federation 117997. ORCID: https://orcid.org/0000-0001-9923-8833. E-mail: npo.med@gmail.com

Yu.D. Vuchenovich — Peoples’ Friendship University of Russia (a Federal Government Autonomous Educational Institution of Higher Education); 6 Miklouho-Maclay St., Moscow, Russian Federation 117198. ORCID: http://orcid.org/0000-0002-7152-4560. E-mail: vuchrd15@mail.ru

A.A. Ziyadinov — Peoples’ Friendship University of Russia (a Federal Government Autonomous Educational Institution of Higher Education); 6 Miklouho-Maclay St., Moscow, Russian Federation 117198. ORCID: http://orcid.org/0000-0002-7296-4584. E-mail: ars-en@yandex.ru

V.A. Novikova — Peoples’ Friendship University of Russia (a Federal Government Autonomous Educational Institution of Higher Education); 6 Miklouho-Maclay St., Moscow, Russian Federation 117198. ORCID: http://orcid.org/0000-0002-6109-7331. E-mail: vladislavan@mail.ru

V.E. Radzinsky — Peoples’ Friendship University of Russia (a Federal Government Autonomous Educational Institution of Higher Education); 6 Miklouho-Maclay St., Moscow, Russian Federation 117198. eLIBRARY.RU SPIN: 4507-7510. ORCID: http://orcid.org/0000-0003-4956-0466. E-mail: radzinsky@mail.ru

 

Доктор.ру

Table 1

Different types of life-threatening septic complications in obstetric patients with various outcomes (n = 60)

t1_1.jpg

Note: Abbreviations in Tables 1–4: MD = maternal death, NM = near miss.

Fig. Sequelae of obstetric septic complications in groups studied, %* P < 0,05

r1_1.jpg

Table 2
Hematological markers of outcomes of obstetric life-threatening septic complications in groups studied

t1_2.jpg

Table 3
Fold increase/decrease in laboratory parameters at peak severity of obstetric septic complications

t1_3.jpg

Table 4
Markers for severity assessment of obstetric septic complications in groups studied

t1_4.jpg

Note: SOFA = Sepsis-related Organ Failure Assessment.

Received: 01.05.2020
Accepted: 12.05.2020

23 July 14:14
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