Nephrological criteria for obstetric Near Miss (critical obstetric conditions). Clinical experience of the Moscow Scientific Research Center Hospital No. 52

Grabovsky V.M., Frolova N.F., Suchkova D.A., Parkhomenko M.V., Zapolskaya N.P., Ivanova E.S., Iskhakov R.T., Artyukhina L.Yu., Usatyuk S.S., Shevchenko N.A., Kotenko O.N., Lysenko M.A.

1) Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department, Moscow, Russia; 2) Russian University of Medicine, Moscow, Russia; 3) Pirogov Russian National Research Medical University, Moscow, Russia

Near Miss in obstetrics (in Russian practice, it corresponds to the term “critical obstetric condition” - COC) is a severe condition of a pregnant or postpartum woman that nearly resulted in death but resulted in recovery thanks to timely medical care. According to the criteria of the World Health Organization (WHO), Near Miss is diagnosed in the presence of organ dysfunction, severe complications, and/or the use of intensive care/critical interventions indicating a risk of death. The importance of nephrological criteria in this context is undeniable: early detection of nephrological disorders (such as elevated creatinine levels, proteinuria, arterial hypertension, thrombocytopenia, HELLP syndrome, thrombotic microangiopathy, etc.) and timely treatment adjustments help prevent the progression of organ failure and reduce the risk of maternal mortality.
This article describes the criteria for critical obstetric conditions (Near Miss) and the nephrological criteria of the COC, illustrated with real clinical examples.

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About the Authors

Vasily M. Grabovsky, Cand.Sci. (Med.), Deputy Chief Physician for Obstetrics and Gynecology, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow 123182; e-mail: GrabovskyVM@zdrav.mos.ru. ORCID: 0000-0002-7048-4827
Nadiya F. Frolova – Cand.Sci. (Med.), Deputy Chief Physician for Nephrology Care, Head of the Interdistrict Nephrology Center, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow 123182; Associate Professor, Department of Nephrology, Russian University of Medicine, Russian Federation. Address: Bldg. 4, 1A Kuskovskaya St., Moscow, 111398; e-mail: nadiya.frolova@yandex.ru. ORCID: 0000-0002-6086-5220
Daria A. Suchkova – Obstetrician-Gynecologist, Head of Women’s Clinic No. 1, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department.
Address: 3 Pekhotnaya St., Moscow 123182; e-mail: gkb52gk2@mail.ru. ORCID: 0009-0003-3701-2267
Maria V. Parkhomenko – Obstetrician-Gynecologist, Department of Pregnancy Pathology, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow 123182; e-mail: maria.mikheeva@bk.ru. ORCID: 0009-0004-0388-9551
Nadezhda P. Zapolskaya – Obstetrician-Gynecologist, Gynecology Department, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department.
Address: 3 Pekhotnaya St., Moscow 123182; e-mail: zapolskaya_1989@mail.ru. ORCID: 0009-0009-5074-0983
Nikolay A. Shevchenko – Cand.Sci. (Med.), Head of the Gynecology Department, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department.
Address: 3 Pekhotnaya St., Moscow 123182; e-mail: Nishevchenko@yandex.ru. ORCID: 0000-0003-4354-1360
Ekaterina S. Ivanova – Cand.Sci. (Med.), Nephrologist, Nephrology Department No.1 (Transplanted Kidney Pathology), Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow 123182; Professor, Department of Nephrology, Russian University of Medicine;
e-mail: katerineiv@mail.ru. ORCID: 0000-0001-7407-5695
Rustam T. Iskhakov – Head of the Nephrology Intensive Care Unit, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow 123182; e-mail: stamius@yandex.ru. ORCID: 0000-0003-2850-4465
Lyudmila Yu. Artyukhina – Cand.Sci. (Med.), Head of Nephrology Department No.1 (Transplanted Kidney Pathology), Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow 123182; Email: arlyu-1404@yandex.ru. ORCID: 0000-0003-3353-1636
Sergey S. Usatyuk – Head of Nephrology Department No. 2, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow 123182; e-mail: usatuk-doc@mail.ru. ORCID: 0000-0002-8742-3860
Oleg N. Kotenko – Dr.Sci. (Med.), Chief Nephrologist, Head of the Moscow City Scientific and Practical Center of Nephrology and Transplanted Kidney Pathology, Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department. Address: 3 Pekhotnaya St., Moscow 123182; Professor, Department of General Therapy, Faculty of Continuous Professional Education, Pirogov Russian National Research Medical University; e-mail: olkotenko@yandex.ru. ORCID: 0000-0001-8264-7374
Maryana A. Lysenko – Dr.Sci. (Med.), Director of the Moscow Clinical Research Center, Hospital No. 52, Moscow Healthcare Department; Professor, Department of General Therapy, Faculty of Continuous Professional Education, Pirogov Russian National Research Medical University; Address: 3 Pekhotnaya St., Moscow 123182;
e-mail: lysenkoMA@zdrav.mos.ru. ORCID: 0000-0001-6010-7975

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