Sepsis in childbirth and the postnatal period as a cause of the regional maternal mortality rate

Abstract

In an article there is analyzed the maternal mortality rate from sepsis in the postpartum period in the Tula region over the period of2001-2015 Sepsis during the intrapartum and postpartum period takes the 3rd place in the structure of the maternal mortality rate in the Tula region, due to sepsis 3 women (8.6%) died out of 35 lethal cases during that period. In absolute numbers, from sepsis every 5 years the 1 woman died, but there was a trend to growth of the portion of this complication from 6.2% (2001-2005) to 14.3% (2011-2015). Among the cases who dead there was the primigravida, 2 multigravida (3rd and 4th pregnancy), the second birth was in 2 cases. There were 2 multiparous residents of the village. In the 1 case sepsis was developed after the delivery, the 1 patient had undergone to cesarean section, 1 pregnant woman died. The death in hospital took place in 2 cases, 1 patient died outside the hospital. The decline of the maternal mortality rate from sepsis directly depends on timely diagnosis, early and adequate treatment in the each particular situation.

Keywords

maternal mortality / sepsis / peritonitis / obstetrics

References

[1] Баранов И.И., Токова З.З. Эпидемиология материнской смертности в мире. Здравоохр. Рос. Федерации. 2012; (1): 13-8.

[2] Серов В.Н. Профилактика материнской смертности. Русский медицинский журнал. 2008; 16 (1): 1-4.

[3] Загидуллина В.М., Рыжова А.С. Материнская смертность как интегральный показатель, отражающий здоровье женщин. Вопросы экономики и права. 2015; (83): 163-6.

[4] Martin G.S. Sepsis, severe sepsis and septic shock: changes in incidence, pathogens and outcomes. Expert. Rev. Antiinfect. Ther. 2012; 10: 701-6.

[5] Senior K. In the dark about sepsis. Lancet Infect. Dis. 2012; 12: 751-2.

[6] Acosta C.D., Harrison D.A., Rowan K., Lucas D.N., Kurinczuk J.J., Knight M. Maternal morbidity and mortality from severe sepsis: a national cohort study. Br. Med. J. Open. 2016; 6(8): e012323.

[7] Cantwell R., Clutton-Brock T., Cooper G., Dawson A., Drife J., Garrod D. et al. Saving mothers’ lives: reviewing maternal deaths to make motherhood safer: 2006-2008. The eighth report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. Br. J. Obstet. Gynaecol. 2011;118 (Suppl. 1): 1-203.

[8] Knight M., Kenyon S., Brocklehurst P. et al. (Eds). Saving Lives, Improving Mothers’ Care - Lessons Learned to Inform Future Maternity Care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-12. Oxford: National Perinatal Epidemiology Unit (NPEU), University of Oxford, 2014.

[9] Bauer M.E., Bateman B.T., Bauer S.T. et al. Maternal sepsis mortality and morbidity during hospitalization for delivery: temporal trends and independent associations for severe sepsis. Anesth. Analg. 2013; 117: 944-50.

[10] Kramer H.M.C., Schutte J.M., Zwart J.J. et al. Maternal mortality and severe morbidity from sepsis in the Netherlands. Acta Obstet. Gynecol. Scand. 2009; 88: 647-53.

[11] Saucedo M., Deneux-Tharaux C. Épidémiologie des morts maternelles en France, 2001-2006. Bull. Epidémiol. Hebd. 2010; (2-3): 10-4.

[12] Александрова Г.А. и др. Основные показатели здоровья матери и ребенка, деятельность службы охраны детства и родовспоможения в Российской Федерации. М.: Минздрав РФ; 2015.

[13] Filippi V., Chou D., Ronsmans C., Graham W., Say L. Levels and causes of maternal mortality and morbidity. In: Black R.E., Laxminarayan R., Temmerman M., Walker N. (Eds). Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities. 3-rd Ed. Washington (DC): The International Bank 24 for Reconstruction and Development / The World Bank; 2016; Vol. 2: Chapt. 3.

[14] Байбарина Е.Н., Филиппов О.С., Гусева Е.В. и др. Материнская смертность в Российской Федерации в 2014 году (методическое письмо). М.: Минздрав России; 2015.

[15] Ушакова Г.А., Артымук Н.В., Зеленина Е.М., Тришкин А.Г., Шукевич Л.Е., Шукевич Д.Л. и др. Сепсис и материнская смертность в Kемеровской области. Российский вестник акушера-гинеколога. 2010; 10 (1): 7-10.

[16] Acosta C., Bhattacharya S., Tuffnell D., Kurinczuk J., Knight M. Maternal sepsis: a Scottish population-based case-control study. Br. J. Obstet. Gynaecol. 2012; 119(4): 474-83.

[17] Mohamed-Ahmed O., Nair M., Acosta C., Kurinczuk J., Knight M. Progression from severe sepsis in pregnancy to death: a UK population-based case-control analysis. Br. J. Obstet. Gynaecol. 2015;122 (11): 1506-15.

[18] Репина М.А. Акушерские технологии XXI века и материнская смертность в Санкт-Петербурге. Вестник Северо-Западного государственного медицинского университета им. И.И. Мечникова. 2010; 2 (2): 49-59.

[19] Smaill F.M., Grivell R.M. Antibiotic prophylaxis versus no prophylaxis for preventing infection after cesarean section. Cochrane Database Syst. Rev. 2014; (10): CD007482.

[20] Kenyon S., Boulvain M., Neilson J.P. Antibiotics for preterm rupture of membranes. Cochrane Database Syst. Rev. 2013; (12): CD001058.

[21] Бадаева А.А., Волков В.Г. Оценка эффективности применения метронидазола при подготовке к кесареву сечению беременных с бактериальным вагинозом. Акушерство, гинекология и репродукция. 2011; 5 (4): 9-13.

[22] French L.M., Smaill F.M. Antibiotic regimens for endometritis after delivery. Review.Cochrane Database Syst. Rev. 2004; (4): CD001067. Update in: Cochrane Database Syst. Rev. 2015; (2): CD001067.

[23] Репина М.А. Сепсис: размышления в связи с материнской смертностью. Журнал акушерства и женских болезней. 2005; LIV (3): 74-82.

RIGHTS & PERMISSIONS

Eco-Vector