Doctor of Medical Sciences, Professor, Gynecologist Viktor Radzinsky is impressed by the work of each unit of the Altai Regional Clinical Perinatal Center "DAR" and noted that this is the most unique project in Russia. Words from an expert who arrived in Barnaul to provide methodological support for organizing an optimal delivery structure medical care women and newborn children of the Altai Territory, according to the official website of the regional Ministry of Health.
“According to the designers, this is the most unique project in Russia. It is necessary to understand that no country in the world will ever be able to organize highly qualified assistance in every remote area. Therefore, it must be concentrated in one place. As, for example, in this new perinatal center, which is part of the medical cluster. The regional multidisciplinary clinical hospital is located next to it. This is exactly what the modern woman needs. The most specialized medical care is the need of the hour. Therefore, I predict a great future for this perinatal center,” noted Viktor Radzinsky.
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The famous doctor appreciated not only the organization of medical care for pregnant women, but also the comfortable conditions in which the patients are at DAR.
“We must not forget that the region is huge. And women come from the most remote areas not for a day or two, but for 2 weeks, a month, and sometimes more. Therefore, the conditions that are organized for them here: separate wards, sanitary conditions “This is what they need,” the professor emphasized.
At the same time, Viktor Radzinsky expressed disappointment over the misunderstanding of the heads of district administrations and some chief doctors district hospitals the need to route patients. He recalled that European indicators, if less than 600 births per year take place in a maternity hospital, then these departments do not reduce maternal mortality. The specialists of such medical organizations do not have the necessary skills. In Russia, the average workload per maternity hospital is 312 births, and in the Altai Territory - 100.
"Due to the availability large quantity somatic diseases at modern woman there is a need for related medical specialists, in carrying out complex diagnostics. Therefore, those who strive to ensure that a woman who is indicated for childbirth medical organization third level, remained to give birth in a first level maternity hospital - they risk their lives,” the professor emphasized.
During the visit, Viktor Radzinsky examined the most complex patients, gave valuable advice and recommendations on their management, including routing within the perinatal center and the procedure for placing newborns, and also gave several lectures for obstetricians and gynecologists of the Altai Territory.
As REGNUM already reported, at the end of April, the head of Roszdravnadzor, Mikhail Murashko, personally visited the DAR perinatal center and assessed the work of its team, which almost from the very opening was forced to work in the conditions of an information war unleashed by the media owned by the Siberian Media Group ( owner of Evalar). Based on the results of checking licensing requirements and conditions, as well as the possibility of implementing procedures for providing medical care at the Altai Regional Clinical perinatal center"(KGBI "AKKPTs") the commission did not find any violations that were previously reported in a number of media.
Let us recall that representatives of the construction contractor, the Self company, noted that the stories and articles deliberately created the impression that construction and delivery took place simultaneously.
“The Roszdravnadzor Commission has established that construction works in the perinatal center (except for the assembly hall) have been completed, the corresponding conclusions have been issued by Rospotrebnadzor for the Altai Territory. All departments of the institution can operate and receive patients. Setup is currently ongoing technological process and equipment with a gradual increase in load,” said the official statement of Roszdravnadzor. It is known that on May 2, “DARE” a boy was born, who became the 100th newborn born in this medical organization.
During his visit to Barnaul, Mikhail Murashko recommended attracting the country's leading experts to provide methodological support for building an optimal structure for organizing medical care for women and newborns, including an academician of the International Academy of Sciences High school, Honored Worker of Sciences of the Russian Federation, Doctor of Medical Sciences, Professor Viktor Radzinsky.
Opening medical center this level was a gift to the obstetrics system of the Altai Territory - at the time of the start of DAR’s work, the bed capacity in the region had already begun to be restructured. And therefore responsibility for necessary help pregnant women, women in labor, postpartum women and newborns in the region during the difficult initial period of reform, the new perinatal center of federal significance took over.
The priority area of work of the perinatal center is the use of high technologies that make it possible to care for premature babies, including those with extremely low body weight. As I told you chief physician center Irina Molchanova, the perinatal center is able to perform this task of national importance with high quality. total area regional perinatal center is 34 thousand. square meters, which houses 5,200 pieces of medical equipment and allows you to solve the most serious problems in obstetrics, gynecology and neonatology. The 24-hour hospital has a capacity of 190 beds, the clinic has a capacity of 120 visits, working in two shifts.
“Mostly patients come from the Altai Territory and the nearby Altai Republic, but there was one case when a pregnant woman originally from Barnaul specially flew from Moscow to give birth to us,” says Irina Vladimirovna. “And thanks to video communication, specialists from the perinatal center conduct online consultations on the management of pregnant women with colleagues from regional hospitals.”
However, despite the fact that the center has developed and put into practice a method of remote consultation, for the provision of medical care severe patients A mobile anesthesiology and resuscitation obstetric team operates from remote areas of the Altai Territory around the clock.
As for the increasingly popular method of remote consultation, according to specialists from the DAR center, the infrastructure of the institution and the network created in the region allow telemedicine and monitoring sessions to be conducted by the perinatal birth center in institutions of the Altai Territory.
"Doctors are leading account for each patient's pregnancy. All information is available to the staff of the perinatal center. Having studied the data on the patient’s health condition, the doctors of the perinatal center give their recommendations, and, if necessary, invite them to Barnaul for further examination and observation,” explains the head physician of DAR.
According to her, there are also patients in the region who are monitored remotely not only by specialists from the regional perinatal center “DAR”, but also by doctors from federal medical institutions. This happens in particularly difficult cases.
Another feature of the work of the DAR perinatal center is its family orientation. Partner birth, close to their physiological course, creating a family atmosphere and a comfortable stay, using modern methods pain relief, as well as the use of the latest perinatal technologies: from putting the newborn to the breast at his request and examining the child in the ward in front of the mother in labor to early discharge - on 3–4 days. According to Irina Molchanova, strict adherence to technologies corresponding to modern development obstetrics is the key to success in the field of obstetrics.
It is also important that the DAR center is part of the Altai medical cluster, located on the territory of a pine forest. “Within the framework of the cluster, there is interaction with the Altai Regional Oncology Dispensary and the Regional Clinical Hospital. Patients are sent to the regional hospital if there is a need to observe them in a multidisciplinary hospital. We periodically invite specialized specialists for consultations if a pregnant woman experiences an exacerbation of somatic diseases,” explains Irina Vladimirovna.
She said that at the DAR perinatal center today a specialized department is being formed for pregnant women suffering from diabetes mellitus. The decision was made taking into account regional and global statistics - over the past few years, the number of pregnant women with diabetes has tripled. Such women belong to a high risk group and are accumulated in a third-level institution, as they require special attention by obstetricians-gynecologists, endocrinologists and neonatologists. This is a new direction in obstetrics, which does not yet work in all regions of Russia.
Although average age doctors - 37 years old, relatively young, it includes representatives of higher education medical institutions and doctors involved scientific work. A number of specialists have completed advanced training and residency at universities in the capital, in particular, at the Department of Obstetrics, Gynecology and Reproductive Medicine of the RUDN University in Moscow. On the basis of the regional perinatal center there is a department of obstetrics and gynecology with a course of additional professional education at the Altai State medical university", where are held practical lessons students and joint research work.
2980Photo by Evgeniy NALIMOV March 1 deputies State Duma Daniil Bessarabov and Nikolay Gerasimenko visited the DAR perinatal center to determine its readiness for work. Chief physician Irina Molchanova showed everything structural units centers, which, as previously promised, are already ready for work. So, on the fifth floor there is a fully equipped laboratory. At the time of the deputies’ visit, a chromosomal analysis was being carried out in one of its blocks, which made it possible to identify fetal pathologies in the early stages of pregnancy. The fourth floor will soon become a permanent site for the center for family health and reproduction, better known as the IVF center. On this moment 1,250 children were born in the Altai Territory with the help of the center’s specialists. Currently, 1,200 IVF procedures are performed in the region per year. This volume allows you to fully satisfy the needs of couples with infertility problems. However, specialists also solve other problems, for example, miscarriage. On the same floor there is an adult intensive care unit, also ready to receive patients. The perinatal center provides for the mother and child to stay together if the baby does not have serious pathologies, requiring the provision specialized assistance. The individual rooms have everything necessary for a convenient and comfortable stay and care for the baby and mother. Even feeding will be organized directly in the wards. This will avoid unnecessary contacts and the spread of nosocomial infection, which is most dangerous for newborns. A convenient large sink-bath with a moving shower will allow you to maintain your newborn’s hygiene without any problems. As the Minister of Health of the Altai Territory Irina Dolgova clarified, the equipment and medical furniture in the wards are of domestic production. All this is of very high quality and has the appropriate certificates. Also in the same department there is a ward intensive care for newborns. In these wards, short-term treatment is carried out, that is, literally on the first day. Therefore, mothers are not there 24/7, but they can visit the baby. The rest of the time, supervision and care are provided nurse. In total, we have two such wards with three beds and two separate boxes - for a total of 8 people,” they said in the postpartum department. The operating rooms are also almost ready. As Irina Molchanova especially emphasized, the center, including the operating rooms, provides the maximum non-contact methods. You can even open the door to the operating room without touching it - special sensors work. Today, neonatologists will not touch the child with their hands, only with special tools and devices. It is non-contact medicine that provides the conditions in which babies born, for example, survive ahead of schedule or with any pathology. At the moment, it is known that the biggest carrier of infection is the hands,” she said. - And we follow this principle in everything. During the visit, Nikolai Gerasimenko and Daniil Bessarabov talked with patients and medical personnel center, appreciated its high organization and A complex approach when solving any problems. The next day, as part of a special commission, State Duma deputy doctor Valery Elykomov visited the new perinatal center. Nikolay Gerasimenko, doctor, member of the State Duma Committee on Health Protection: I am the head of the federal project “Healthy Future” of the United Russia party. One of its directions is monitoring the implementation of the construction of perinatal centers throughout Russia. Therefore, it was important for me to see with my own eyes what was happening here. Now I can say that I am shocked by the organization of the center’s work. The Altai Perinatal Center is the largest of the 32 that are being built throughout Russia. Its 190 beds and the capabilities of the perinatal center on Popova provide powerful potential for reducing infant and maternal mortality. It is impossible for assessments medical institutions given by amateurs. Specialists from Roszdravnadzor and Rospotrebnadzor work with the center and evaluate everything objectively. I can say for sure that the DAR center deserves the highest rating. By the end of the first half of the year, I believe it should reach its capacity. Daniil Bessarabov, member of the State Duma Committee on Labor, social policy and Veterans Affairs: This is a unique facility, including in terms of location, medical equipment, architecture and process logistics. The professionals who work here are trained in leading clinics in the country and have extensive personal experience. But the most important assessment, in my opinion, has already been received from the lips of expectant mothers. During the last regional week, I received more than one call from remote areas of my district. Women want to give birth within the walls of this particular center, and this means a high degree of trust in specialists. Any enterprise needs time to reach its planned capacity so that all processes work normally. The perinatal center, as a new institution, has just begun its work, and we need to help it get on its feet, form a team, organize work around the edge and then with confident steps move forward. Valery Elykomov, doctor, member of the State Duma Committee on Health Protection: Today we spent two and a half hours touring the new perinatal center. Today it is a working structure for those types of licensed activities for which it currently accepts patients. Monitoring of pregnant women, the possibility of transporting them here and the readiness of all services and bases to work in emergency conditions. It is also important that the perinatal center can observe newborns, if necessary, for up to three months. As a former chief physician of several medical institutions I can say that at a glance magic wand it is impossible to launch a large structure. I remember well the opening of the regional clinical hospital- at first there were only 40 beds, then 270, then 870 and today - 1265. But we have never had institutions of this type like the DAR center. Women should know that our region has enough strength, resources and qualifications to save the life of a mother and child if necessary.
Opinions
A rumor has spread across Barnaul - to the new perinatal center "Dar", on the mountain, they are taking women to give birth without appropriate indications. In particular, they say that they send there patients from Barnaul maternity hospital No. 2 who do not have any risks or complications.
Why is this necessary? Perhaps for show. Some people assume that they can’t yet have a difficult birth in an unfinished building - no necessary conditions and equipment. But normal childbirth - please. Thus, statistics and indicators are made, justifying huge funding.
Call to the maternity hospital
"Komsomolskaya Pravda - Barnaul" decided to check this rumor and turned to the chief doctor for comment Maternity hospital №2 Lyudmila Ananina.
Yes, we send women there. But only those who have testimony, everything is as it should be,” Lyudmila Ananyina denied the rumors. - This center officially operates a clinical diagnostic department. They keep some of them, and some they send back to us. It all depends on the degree of risk. They keep the group for themselves high risk. Everything is regulated by the orders of the regional Ministry of Health, everyone follows them. There are no pitfalls here.
The doctor found it difficult to name the exact number of women giving birth who remained in the perinatal center. But she noted that these are “not such large flows.” But, according to her, many women receive consultations there.
Conditions in the center are now excellent. I was there personally and I can confirm this,” Lyudmila Ananyina emphasized.
Regime object?
Meanwhile, the other day a story about “The Gift” was aired on the NTV channel. Capital journalists assure that the conditions are far from excellent. The facility resembles a security facility - they were allowed with cameras only on the first floor (explaining that there was a quarantine in force due to colds). And on the floor above there was construction going on.
Now in some parts of the building there is simply no finishing, in some places there are no partitions or floors. The design capacity of the center is 190 beds, but 39 are occupied so far. Since its opening, on December 22, only seven children have been born here! - the story says.
And as it says official statistics On average, about 75-79 children are born per day in the region (in Barnaul - 25-29). And there are quite a lot of expectant mothers who are at risk and have indications for childbirth in a perinatal center. But for what reasons do they not go there?
Many questions remain. To get answers to them, Komsomolskaya Pravda sent a request to the Ministry of Health of the Altai Territory. We can only wait for the officials' response.
Food for thought
In general, the federal program for the construction of perinatal centers in the country should create 32 such health care institutions. Construction of the facilities began in 2013 and should have been completed in the past. In case of failure to fulfill obligations, the regions must return the money allocated for the construction of the centers.
By the end of 2016, out of 32 centers, 15 were commissioned. Including the Altai “DAR”, which, although officially opened, was essentially just for show, since there are still full swing Construction work is underway, and patients are currently only accepted on one of the four floors of the center.
Considering the situation where regions are lagging behind schedule, at the end of December 2016, Prime Minister Dmitry Medvedev asked governors to “accelerate” and gave a delay in the commissioning of facilities until the end of 2017.
It can be assumed that the deadlines were not postponed by chance - so that fully completed facilities could be properly completed, equipped and put into operation. What prevented the regional authorities from doing this? The unfinished building was hastily opened on December 22, 2016, as if they were being rushed. But there is still a whole year ahead.
And one more question: why is there so much gossip and omissions around the center? It would seem that there is nothing to hide, because the center is in plain sight for everyone! Have you put an unfinished object into production? This is what we need to explain to people: we are continuing to work according to schedule, and in the end everything will definitely be at the highest level. Tell it like it is - without tricks and secrets, without demonstrating a grand discovery and childbirth, which people called “demonstrative”. In the end, we have what we have - the situation gave rise to a lot of negative rumors and spoiled the reputation of the priceless “Dar”.
KP Help
The construction of the Dar center (its area is 34 thousand square meters) is taking place within the framework of the federal program for the construction of perinatal centers. The Altai Territory was included in this program in 2011. The bulk of funds from the federal and regional budgets were invested in 2015 and 2016.
The object is undoubtedly important and necessary. For the Altai Territory this is new step in obstetrics. Maternity hospital or perinatal center such high level has not been in the region yet. 3 billion rubles were spent on the construction of Dar. It is planned that there will be departments of gynecology, pathology of pregnant women, pathology of newborns and premature babies, a prenatal diagnostics center, intensive care unit, IVF center and much more. It is expected that patients will be able to receive state-of-the-art medical care here.
In the Altai perinatal center "DAR" all planned departments are operational: gynecological, maternity, postpartum, departments of pregnancy pathology and pathology of newborns, obstetric hospital. More than 30 babies have already been born here. Patients are also consulted by doctors from the entire mountain cluster, which includes seven medical institutions.
Contact via Skype - hospital in Shelabolikha. Doctors of the DAR perinatal center call the districts every week, study the regional register of pregnant women and invite women from high-risk groups to see them. Yulia Shumkova recently gave birth to a son at the perinatal center. She came to DAR twice during her pregnancy: she has a pathology of the thyroid gland.
As Svetlana Teplukhina, an obstetrician-gynecologist at the perinatal center, explained, “this can be any pathology: pregnant women are observed with us hypertension, With bronchial asthma, with other heavy extragenital pathologies. And therefore we carry out hospitalization in the institution that is indicated for the woman at this stage.”
Maria Vorobyova is expecting twins. She has an artificial heart valve. Gynecologists are constantly in touch with regional clinical cardiologists. And Tatiana asks not to show her face. She has chronic renal failure. Having been diagnosed with pregnancy being contraindicated, the woman took the risk of carrying the baby to term and now goes for hemodialysis every day. In Russia, there are cases of successful births with this diagnosis: in Irkutsk and Orenburg. In Barnaul they took on a difficult case, but warned the woman about another possible outcome.
Tatyana, a patient at the perinatal center, shared: in general, they told me that getting pregnant... It’s not that it’s contraindicated, but then it happened, and my husband and I decided to continue the pregnancy. What if everything will be fine? What if everything works out?
As Elena Draganik, director of the Barnaul dialysis center, says, “the management of such patients is very complex, this involves joint meetings with gynecologists. This is a lot of joint work between doctors over the course of 9 months.” For the sake of great work in the name of life, they built the DAR perinatal center. In the world and in the region, the leading position in the structure of maternal mortality is occupied by somatic pathologies - this is when, during pregnancy, women experience worsening chronic diseases. The Altai Territory is now ready to resist this negative trend.
And such a “fine line of management of such patients, it can only be carried out in the community of all doctors who are concentrated on this site: KKB and the perinatal center. - Only in such a complex can we preserve the health of the mother and get healthy child", Irina Molchanova, chief physician of the DAR perinatal center, is sure.
Meanwhile, the Barnaul authorities announced a competition to develop a project for improving the territory of the medical cluster. 3.5 million rubles are allocated for this from the city budget. And the regional government promised to finance the work itself. The exact amounts will be announced after the project is developed. So, next to the Dar perinatal center, the road will be widened, several parking lots will be created and additional traffic lights will be installed. Landscaping should begin in the summer.
Also in the area between the Dar perinatal center and Federal Center Traumatology, it is planned to equip a recreation area with benches and walking paths. In addition, city authorities want to install additional traffic lights on the Zmeinogorsky tract next to the Dynamo ski base. Now it is difficult to travel there, including for ambulances.
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