Critical near-miss conditions in obstetrics: difficulties in diagnosis and therapy

DOI

https://dx.doi.org/10.18565/aig.2020.3.228-237

Pyregov A.V., Shmakov R.G., Fеdorova Т.А., Yurova M.V., Rogachevsky О.V., Grishchuk К.А., Strelnikova E.V.
1) Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow, Russia

Background. A near-miss (NM) woman is a pregnant or puerperal woman in the critical condition - near death during pregnancy, childbirth, or within 42 days after delivery and who has survived the specified period. The management of obstetric patients who are on the verge of life and death (near miss) always presents great difficulties and requires a multidisciplinary approach, the use of modern diagnostic and treatment methods, and the mobilization of significant material investments. Analysis of obstetric near misses is the subject of a systematic study, which can assess the quality and level of organization of the work at the health care facilities providing specialized obstetric/gynecological care.
Case report. The paper analyzes the management and treatment of a patient from the near-miss category with HELLP syndrome, sepsis, secondary thrombotic microangiopathy, and acute kidney injury, which are manifested after operative delivery.
Conclusion. The timely and rapid routing of a patient to a third-level obstetric health care facility, the use of modern high-tech diagnostic and treatment methods contributed to the preservation of life in the patient and her hospital discharge in satisfactory condition.

pregnancy

near-miss

HELLP syndrome

sepsis

thrombotic microangiopathy

extracorporeal hemocorrection methods

Full text (in Russian)

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Received 25.10.2019

Accepted 29.11.2019

Aleksey V. Pyregov, MD, associate professor, head of the Department of Anesthesiology and Resuscitation of FSBI NMRC for OG&P named after Acad. V.I. Kulakov
Ministry of Health of Russia. Phone:+74954387777. E-mail: a_pyregov@oparina4.ru
Adress:117997, Russia, Moscow, Ac. Oparin str. 4.
Roman G. Shmakov, MD, professor, Director of the Institute of obstetrics of FSBI NMRC for OG&P named after Acad. V.I. Kulakov Ministry of Health of Russia. Phone:+74954382489. E-mail: r_shmakov@oparina4.ru
Adress:117997, Russia, Moscow, Ac. Oparin str. 4.
Tatiana A. Fedorova, MD. professor, Chief of transfusional department of FSBI NMRC for OG&P named after Acad. V.I. Kulakov Ministry of Health of Russia.
Phone: +7(495) 438-71-35 E-mail: t_fyodorova@oparina4.ru https://orcid.org/0000-0001-6714-6344
Adress:117485, Russia , Moscow , acad. Oparin st. 4.
Maria V. Yurova, Postgraduate Student of the Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), resident of FSBI NMRC for OG&P named after Acad. V.I. Kulakov Ministry of Health of Russia.
E-mail: m_yurova@oparina4.ru; https://orcid.org/0000-0002-0179-7635. Address:117485, Russia, Moscow, Acad. Oparin, 4.
Oleg V. Rogachevskiy, MD, professor, head of the Department of extracorporeal methods of treatment and detoxification, Professor Department of Anesthesiology and Resuscitation of FSBI NMRC for OG&P named after Acad. V.I. Kulakov Ministry of Health of Russia. Phone: +7(495)438-71-35.
E-mail: о_rogachevskiy@oparina4.ru4. https://orcid.org/0000-0002-4332-430X
Address:117485, Russia, Moscow, Acad. Oparin, 4.
Konstantin I. Grischuk, physician of the Department of Anesthesiology and Resuscitation of FSBI NMRC for OG&P named after Acad. V.I. Kulakov Ministry of Health of Russia. Phone: +7(495) 438-77-77. E-mail: k_grishuk@oparina4.ru
Address: 117485, Russia, Moscow, st. Acad. Oparina , 4.
Elena V. Strelnikova, MD, doctor of transfusional department of FSBI NMRC for OG&P named after Acad. V.I. Kulakov Ministry of Health of Russia.
Теl.: +7(495) 438-71-35. E-mail: е_strelnikova@oparina4.ru
Address: 117997, Russia, Moscow, acad. Oparin st. 4.

For citation: Pyregov A.V., Shmakov R.G., Fеdorova Т.А. Yurova M.V., Rogachevsky О.V., Grishchuk К.А., Strelnikova E.V. Critical near-miss conditions in obstetrics: difficulties in diagnosis and therapy.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2020; 3: 228-37. (In Russian).
https://dx.doi.org/10.18565/aig.2020.3.228-237

Critical near-miss conditions in obstetrics: difficulties in diagnosis and therapy

Pyregov A.V., Shmakov R.G., Fеdorova Т.А., Yurova M.V., Rogachevsky О.V., Grishchuk К.А., Strelnikova E.V.

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