scholarly journals Analysis of obstetric «near miss» cases in the Ryazan region

2019 ◽  
Vol 12 (4) ◽  
pp. 30-36 ◽  
Author(s):  
I. K. Мamontova ◽  
T. V. Shevlyakovа ◽  
E. I. Petrova
Keyword(s):  
Maternal Mortality ◽  
Medical Care ◽  
Near Miss ◽  
Critical Conditions ◽  
Normal Term ◽  
Caesarean Section Delivery ◽  
Term Delivery ◽  
Quality Of Medical Care ◽  
Uterine Scar

Although maternal mortality cases in Russia have become rare, the problem of their prevention remains relevant. To enforce the preventive measures, an analysis of critical conditions and «near miss» cases in obstetrics is commonly used. As a result, the quality of medical care in obstetric institutions improves. Aim: to assess the character and incidence of critical situations in obstetrics practice over the Ryazan region in 2015-2017 and to analyze the failures in medical care that led to such situations. Materials and methods. We analyzed 46 «near miss» cases and 1 case of maternal death recorded in the Ryazan region in 2015-2017. Results. The leading cause of critical conditions in obstetrics found in the Ryazan region was hemorrhage following an emergency caesarean section delivery. In most cases, bleeding was caused by pregnancy complications, although extragenital conditions also contributed to the development of the «near miss» situations. The main indication for emergency delivery was the premature detachment of a normally located placenta; in the normal term delivery, it was an inconsistent uterine scar after cesarean section and the accompanying pathology, such as placenta accreta. Conclusion. Considering the «near miss» cases as a separate group of obstetrics conditions contributes to the prevention of maternal mortality and improves the healthcare standards in obstetric institutions.

scholarly journals Monitoring in obstetric critical care (“maternal near miss”) in the Northwestern Federal District of the Russian Federation in 2018-2019

2021 ◽  
Vol 70 (1) ◽  
pp. 5-18
Author(s):  
Vitaly F. Bezhenar ◽  
Oleg S. Filippov ◽  
Leila V. Adamyan ◽  
Igor M. Nesterov
Keyword(s):  
Maternal Mortality ◽  
Medical Care ◽  
Russian Federation ◽  
Federal District ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Integral Model ◽  
Internal Quality ◽  
Quality Of Medical Care ◽  
The Russian Federation

This article presents data of monitoring critical obstetric conditions (maternal near miss) for the purpose of auditing the quality of medical care and prevention of maternal mortality, obtained on the basis of an analysis of statistical data from eleven federal subjects of the Northwestern Federal District of the Russian Federation for 2018-2019. We characterized the critical obstetric conditions that allow avoiding maternal mortality cases, which, in modern legal practice, most often require forensic examinations on the fact of providing obstetric and gynecological medical care of inadequate quality. We determined that the main causes of maternal mortality cases (83.1% in 2018 and 84.0% in 2019) were massive obstetric bleeding and complications of severe preeclampsia, which more often occurred during childbirth and the first days of the postpartum period. All patients who survived a near death condition belonged to the group of high obstetric and perinatal risk, but most of them were delivered in obstetric hospitals of the second level, with more than half of the women by caesarean section. We discussed the main ways of preventing and reducing the incidence of critical obstetric conditions and maternal mortality based on the improved modern integral model of internal quality control of medical care in obstetric institutions. We also discussed the findings based on the introduction into practice of medical, organizational and methodological (including telecommunication and other) technologies aimed at increasing professional competencies in the regions of the country. Special attention is drawn in this article to the need to systematize and develop uniform and clear criteria for assessing critical obstetric conditions.

ON THE ISSUE OF NUTRITION IN THE CONDITIONS OF A PANDEMIC OF A NEW CORONAVIRUS INFECTION COVID-19

2021 ◽  
pp. 150-156
Author(s):  
Марина Михайловна Романова ◽  
Алексей Викторович Чернов
Keyword(s):  
Medical Care ◽  
Critical Conditions ◽  
Healthy Individuals ◽  
Scientific Medicine ◽  
Inpatient Settings ◽  
Quality Of Medical Care ◽  
Coronavirus Infection ◽  
Macro And Micronutrients ◽  
Comprehensive Study

Вопросы питания занимают особое место в научной медицине и практическом здравоохранении, в условиях пандемии новой коронавирусной инфекции нуждаются в дальнейшем всестороннем изучении и развитии. Статья посвящена исследованию и анализу роли и возможностей профилактического и лечебного питания при оказании медицинской помощи в разных медицинских организациях в условиях пандемии новой коронавирусной инфекции COVID-19. Определены особенности оптимальной организации питания здоровых лиц и пациентов с новой коронавирусной инфекции с течением разной тяжести при лечении в амбулаторных и стационарных условиях, включая пациентов, находящихся в критических состояниях. Обеспечение потребностей в макро- и микронутриентах, поддержание и нормализация пищевого и метаболического статуса пациента с COVID-19 во многом определят благоприятный исход для больного с новой коронавирусной инфекцией. Полученные данные следует учитывать при проведении профилактических и лечебных мероприятий отдельным категориям пациентов на всех этапах оказания медицинской помощи. Оптимизация организации профилактического и лечебного питания пациентов с новой коронавирусной инфекцией COVID-19 на всех этапах оказания медицинской помощи будет способствовать снижению первичной и общей заболеваемости, количеству осложнений, смертности; повышению качества оказания медицинской помощи Nutrition issues occupy a special place in scientific medicine and practical healthcare, in the context of a pandemic of a new coronavirus infection, they need further comprehensive study and development. The article is devoted to the study and analysis of the role and possibilities of preventive and curative nutrition in the provision of medical care in various medical organizations in the context of the pandemic of the new coronavirus infection COVID-19. The features of optimal nutrition organization of healthy individuals and patients with a new coronavirus infection with a course of varying severity during treatment in outpatient and inpatient settings, including patients in critical conditions, are determined. Ensuring the needs for macro- and micronutrients, maintaining and normalizing the nutritional and metabolic status of a patient with COVID-19 will largely determine a favorable outcome for a patient with a new coronavirus infection. The data obtained should be taken into account when carrying out preventive and curative measures for certain categories of patients at all stages of medical care. Optimization of the organization of preventive and curative nutrition of patients with the new coronavirus infection COVID-19 at all stages of medical care will contribute to reducing primary and general morbidity, the number of complications, mortality; improving the quality of medical care

scholarly journals Risk Factors of Maternal Mortality in Calabar

2020 ◽  
Vol 1 (2) ◽  
pp. 83-92
Author(s):  
Uduakobong P. Akpabio ◽  
Pius U. Angioha ◽  
Chiamaka V. Egwuonwu ◽  
Esther B. Awusa ◽  
Magareth N. Ndiyo
Keyword(s):  
Maternal Mortality ◽  
Medical Care ◽  
Cultural Practices ◽  
Care Delivery ◽  
Quality Data ◽  
Design Data ◽  
Health Centres ◽  
Quality Of Medical Care ◽  
The Government

Maternal mortality remains unacceptably high despite both local and international programs carried at reducing the incidence. Nigeria suffers from 800 maternal death per 100,000 births. This study examines the extent to which cultural practices and quality of medical care determines maternal mortality in Calabar, Cross River State. Using the survey research design, data were collected from 400 women aged between 15 and 49 from Calabar using a self-developed structured questionnaire. The participants were selected using cluster and purposive sampling technique. Data collected from the field was analyzed using descriptive statistics and regression analyses at 0.05 confidence level. Result from the analysis revealed that uncivilized cultural practices lead to high maternal mortality. 75.64 per cent of the participant reported cases of complications during birth in the hands of traditional birth attendants. cultural practices account for 49 per cent of the variation in maternal mortality. Also, result revealed that poor care delivery or quality of medical care leads to high maternal mortality. 54.14 per cent of the participants reported that the cost of medical care for a pregnant woman in the hospital is too expensive. 69.43 per cent reported there have been deaths as a result of lack of care in hospitals. Based on these findings There is need for the government and its health ministry to increase the number of primary health centres in the nation as well as strengthen this health centres to collect high-quality data to respond to the needs and priority of women and girls amongst others.

scholarly journals Audit of quality of care in critical conditions in obstetrics (“near miss”)

2016 ◽  
Vol 65 (4) ◽  
pp. 15-23 ◽  
Author(s):  
Eduard K. Ailamazian ◽  
Vladimir O. Atlasov ◽  
Konstantin V. Yaroslavsky ◽  
Viktor K. Yaroslavsky
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Quality Of Care ◽  
Near Miss ◽  
Critical Conditions ◽  
Pregnancy And Childbirth ◽  
Quality Of Medical Care ◽  
Pregnancy And Birth ◽  
Main Factor

The article presents material about critical states in obstetric and gynecologic practice (“near miss”), obtained on the basis of their own research, as well as the data of domestic and foreign authors. It is shown that the main factor determining the outcome of the pregnancy and birth, is the quality of medical care provided to the woman. The characteristics of “near miss”, indicated the risk factors for its occurrence. A measure of the health care until serious complications of pregnancy and childbirth, as well as possible ways to reduce the frequency of their development.

scholarly journals The influence of the using “near-miss” on some obstetric bleeging indicators

2018 ◽  
Vol 67 (1) ◽  
pp. 13-19
Author(s):  
Guldzhahon K. Davlyatova ◽  
Marhabo Ya Kamilova ◽  
Dilnoza M. Rakhmatulloeva
Keyword(s):  
Maternal Mortality ◽  
Medical Care ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Case Review ◽  
Maternity Hospitals ◽  
Implementation Of Standards

The article reviews the use of maternal near-miss in maternity hospitals of Tajikistan and its effect on selected indicatior of maternal bleedings. The implementation of standards and the use of near miss case review in 20 maternity hospitals was shown to decrease the rate of maternal bleedings, especially hypotonic bleedings, the rate of critical hypotonic bleedings, the rate of hysterectomy, and the ratio between deaths due to maternal bleeding in these maternity hospitals and overall maternal bleeding mortality. Our results confirm, that the use of “near-miss” strategy improves the quality of maternal medical care and allows to decrease overall maternal mortality.

Responsibility for a quality of medical care provided via telemedicine

2018 ◽  
Vol 2018 (1-2) ◽  
pp. 9-15
Author(s):  
Morozov S.P. ◽  
◽  
Vladzymyrskyy A.V. ◽  
Varyushin M.S. ◽  
Aronov A.V. ◽  
...  
Keyword(s):  
Medical Care ◽  
Quality Of Medical Care

METHODOLOGICAL APPROACH TO EVALUATING THE EFFECTIVENESS OF RESOURCE USE BY MEDICAL ORGANIZATIONS

2020 ◽  
Vol 3 (7) ◽  
pp. 62-69
Author(s):  
S. S. BUDARIN ◽  
Keyword(s):  
Medical Care ◽  
Resource Use ◽  
Methodological Approach ◽  
Use Of Resources ◽  
Quality Of Medical Care ◽  
Methodological Approaches ◽  
Performance Audit ◽  
Available Resources

The article reveals methodological approaches to evaluating the effectiveness of the use of resources of medi-cal organizations in order to improve the availability and quality of medical care based on the application of the methodology of performance audit; a methodological approach to the use of individual elements of the efficiency audit methodology for evaluating the performance of medical organizations and the effectiveness of the use of available resources is proposed.

Evaluation of medical care for Diabetic and Hypertensive patients in primary care in Mexico: Observational retrospective study (Preprint)

2020 ◽  
Author(s):  
Agustin Lara-Esqueda ◽  
Sergio A Zaizar-Fregoso ◽  
Violeta M Madrigal-Perez ◽  
Mario Ramirez-Flores ◽  
Daniel A Montes-Galindo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Serum Lipids ◽  
Quality Care ◽  
Premature Death ◽  
Current Standard ◽  
Anonymized Data ◽  
Quality Of Medical Care

BACKGROUND Diabetes Mellitus is a worldwide health problem and the leading cause of premature death with increasing prevalence over time. Usually, along with it, Hypertension presents and acts as another risk factor that increases mortality risk. Both diseases impact the country's health while also producing an economic burden for society, causing billions of dollars to be invested in their management. OBJECTIVE The present study evaluated the quality of medical care for patients diagnosed with diabetes mellitus (DM), hypertension (HBP), and both pathologies (DM+HBP) within a public health system in Mexico, according to the official Mexican standard for each pathology. METHODS 45,498 patients were included from 2012 to 2015. All information was taken from the electronic medical records database, exported as anonymized data for research purposes. Each patient record was compared against the standard to test the quality of medical care. RESULTS Glycemia with hypertension goals reached 29.6% in DM+HBP, 48.6% in DM, and 53.2% in HBP. The goals of serum lipids were reached by 3% in DM+HBP, 5% in DM, and 0.2% in HBP. Glycemia, hypertension, and LDL cholesterol reached 0.04%. 15% of patients had an undiagnosed disease of diabetes or hypertension. Clinical follow-up examinations reached 20% for foot examination and clinical eye examination in the whole population. Specialty referral reached 1% in angiology or cardiology in the whole population. CONCLUSIONS Goals for glycemic and hypertension reached 50% in the overall population, while serum lipids, clinical follow-up examinations, and referral to a specialist were deficient. Patients who had both diseases had more consultations, better control for hypertension and lipids, but inferior glycemic control. Overall, quality care for DM and/or HBP has not been met according to the standards. While patients with DM and HBP do not have a current standard to evaluate their own needs.

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