Evaluation preventable perinatal losses on the example of large maternity hospital general hospital

То study the dynamics of the preventability of perinatal losses according to a large maternity hospital General Hospital using the Nordic-Baltic system taking into account the transition to WHO criteria. Materials were the 605 autopsy protocols of the dead fetuses and newborns in a maternity hospital major General Hospital (Novosibirsk) in the period from 2010 to 2013. Unavoidable losses during the study period of observation have a distinct downward trend, which is associated with improvements in prenatal diagnosis of congenital malformations and abortion up to 22 weeks. After the transition to WHO criteria in 2012 the indicators of perinatal losses increased due to category III relating to conditionally preventable losses, and categories, uniting the death of the newborn (VIII-XII category) related to preventable losses. After the transition to WHO criteria share of preventable losses reached more than 90%, which represents a significant decrease in perinatal mortality reserveЦель - изучить динамику предотвратимости перинатальных потерь по данным родильного дома крупной многопрофильной больницы при использовании Скандинавско-Балтийской системы с учетом перехода на критерии ВОЗ. Материалами послужили 605 протоколов патологоанатомических вскрытий плодов и умерших новорождённых в родильном доме крупной многопрофильной больницы (г. Новосибирск) в период с 2010 по 2013 г. Непредотвратимые потери за исследованный период наблюдения имеют отчетливую тенденцию к снижению, что связано с улучшением пренатальной диагностики врожденных пороков развития и прерывания беременности до 22 недель. После перехода на критерии ВОЗ в 2012 г. показатели перинатальных потерь увеличились за счет III категории, относящихся к условно предотвратимым потерям, и категорий, объединяющих смерть новорожденных (VIII-XII категории), относящихся к предотвратимым потерям. Доля предотвратимых потерь после 2012 г. достигла более 90%, что представляет собой значительный резерв снижения перинатальной летальност

Assessment of risks for bleeding during preterm labor from the causes of bleeding

Objective. To study the possibilities of predicting the risks of abnormal and massive blood loss during preterm labor on the basis of the causes of bleeding. Material and methods. The authors carried out a prospective analysis of 1442 deliveries complicated by bleeding. Discriminant analysis was made to classify intergroup differences in the presence of abnormal and massive blood loss and in the absence of bleeding during preterm and term labor. Resu1ts. The relative risk of abnormal or massive blood loss on the basis of the causes of bleeding in preterm labor; the signs determining intergroup differences in the presence of abnormal and massive blood loss and in the absence of bleeding during preterm and term labor; and the signs indicating the risks of hypotonic bleeding were assessed. Conclusion. Preterm labor is threatened by abnormal and massive blood loss. The structure of the main causes of abnormal and massive blood loss is different in preterm and term labor, which leaves a resource to choose preventive and therapeutic measures. © 2019, Bionika Media Ltd. All rights reserved