Central Asian Journal of Medicine


Objective: Carry out an audit of critical situations (near miss) for obstetric hemor rhages, identify unused opportunities for improving the quality of care provided. Materials and methods: 22 cases of critical situations (near miss) in obstetric hemorrhages in the Republican Perinatal center (RPC) were audited, according to the methodology in accordance with the national standard for «near miss» [1]. Results: A total of 825 cases of obstetric hemorrhages (from 17480 births) occurred in the Republican Perinatal center for 3 years (2015-2017), the frequency of which was 4.7%. In their structure, postpartum hemorrhages were 1.9%, premature placental abruption - 2,% (350) and placenta previa - 0.8% (147). Based on the «near miss», recommendations were developed and implemented for the organization of emergency care for bleeding, for training staff in the standards for managing bleeding and for providing drugs and equipment. Conclusion: The introduction of «near miss» contributes to the timely and adequate provision of emergency obstetric care, strengthens the multidisciplinary team, promotes the role of midwives, improves birth outcomes, helps reduce maternal mortality, identifies obstetrics areas for the development of new protocols and standards. All this in general contributes to the improvement of the quality of the medical care provided, raises the satisfaction of patients and her family from the help received in the obstetrical institution.

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1. Natsional'nyy standart po auditu kriticheskikh situatsiy v akusherskoy praktike i konfidentsial'nomu issledovaniyu sluchayev materinskoy smertnosti v rodovspomogatel'nykh uchrezhdeniyakh Respubliki Uzbekistan. – Tashkent, 2015. – 119 s. 2. Hodorogea S. Piloting near miss case reviews in Kazakhstan: improving quality of maternal care // Entre Nous. – 2010. – Vol. 70. – P. 28-29. 3. Hutchinson C., Lange I., Kanhonou L. et al. Exploring the sustainability of obstetric near miss case reviews: a qualitative study in the South of Benin // Midwifery. – 2010. – Vol. 26, №5. – P. 537-543. 4. Sukhanberdiyev K., Ayazbekov A., Issina A. et al. Initial experience of Near Miss Case Review: improving the management of haemorrhage // Entre Nous. – 2011. – Vol. 7, №4. – P. 18-19. 5. Tunзalp O., Hindin M.J., Souza J.P. et al. The prevalence of maternal near miss: a systematic review // Brit. J. Obstet. Gynaec. – 2012. – Vol. 119, №6. – P. 653-656. 6. Tunзalp Ц., Souza J.P. Maternal near-miss audits to improve quality of care // Brit. J. Obstet. Gynaec. – 2014. – Vol. 121, №4. – P. 102-104.



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