OBSTETRIC HEMORRHAGES AS A CAUSE OF MATERNAL DEATH IN THE TULA REGION

The aim of the work is to analyze the cases of maternal death from bleeding in the Tula region of Russia for 15 years. Materials and methods. We performed a retrospective analysis of anonymized copies of primary medical records, protocols of autopsy, forensic and statistical reports, as well as expert records and reviews on maternal death cases, from January 01. 2001 to December 31. 2015. Results . Bleeding represents the second common cause of maternal deaths in the Tula region. During this 15-year period, six women died: four – from hypotonia or atonia of the uterus, and two – from premature detachment of the normally located placenta. All six women were multiparous; four of them had a third birth. Three women did not undergo due observations in the women's health clinic. The median age was 32 years (27-38 years). In three cases, the death occurred outside the hospital. Conclusion. The optimal way to reduce maternal deaths from bleeding may be the development of an individual algorithm for preventing bleeding in patients at risk.