Doctor of Medical Sciences, Professor, Gynecologist Viktor Radzinsky was impressed by the work of each department of the Altai Regional Clinical Perinatal Center "DAR" and noted that this is the most unique project in Russia. The words of the expert who arrived in Barnaul in order to provide methodological support for the organization of an optimal structure for the provision of medical care to women and newborn children in the Altai Territory, are quoted by 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 never in any country in the world will it be possible to organize highly qualified assistance in every remote area. Therefore, she must concentrate 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 a modern woman needs. The most specialized medical care is a necessity of time. Therefore, I predict a great future for this perinatal center, ”said Viktor Radzinsky.
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The well-known doctor appreciated not only the organization of medical care for pregnant women, but also the comfortable conditions in which the patients are in the "DAR".
“Do not forget that the region is huge. And from the most remote areas women come 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 at the lack of understanding of the heads of district administrations and some chief doctors of district hospitals in the need to route patients. He recalled that according to European indicators, if less than 600 births take place in a maternity hospital a year, then these departments do not reduce maternal mortality. The specialists of such medical organizations do not have the necessary skills. In Russia, the average burden on a maternity hospital is 312 deliveries, and in the Altai Territory - 100.
“Due to the presence of a large number of somatic diseases in a modern woman, there is a need for related medical specialists, in carrying out complex diagnostics. Therefore, those who are trying to ensure that a woman who is shown childbirth in a third-level medical organization remains to give birth in a first-level maternity hospital is risking their lives, ”the professor emphasized.
During the visit, Viktor Radzinsky examined the most difficult patients, gave valuable advice and recommendations on their management, including routing within the perinatal center and the order of placement of newborns, and also gave several lectures for obstetricians and gynecologists of the Altai Territory.
As reported by IA REGNUM, at the end of April, the head of Roszdravnadzor Mikhail Murashko personally visited the DAR perinatal center and assessed the work of his team, which almost from the very opening was forced to work in the conditions of an information war unleashed by the media belonging to the Siberian Media Group ( owner of "Evalar"). Based on the results of checking the licensing requirements and conditions, as well as the possibility of fulfilling the procedures for the provision of medical care in the Altai Regional Clinical Perinatal Center (KGBUZ AKKPTs), the commission did not find any violations previously reported in a number of media outlets.
As a reminder, representatives of the construction contractor - the Self company - noted that the stories and articles deliberately created the impression that construction and delivery took place at the same time.
“The Roszdravnadzor Commission has established that construction work in the perinatal center (except for the assembly hall) has been completed, the corresponding conclusions have been issued by Rospotrebnadzor in the Altai Territory. All departments of the institution can work and receive patients. At present, adjustment of the technological process and equipment with a gradual increase in load is underway, ”the official statement of Roszdravnadzor said. It is known that on May 2, "DARE" was born a boy who became the 100th newborn born in this medical organization.
During his visit to Barnaul, Mikhail Murashko recommended attracting leading specialists of the country for methodological support in building an optimal structure for organizing medical care for women and newborn children, including Academician of the International Academy of Sciences of the Higher School, Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor Viktor Radzinsky.
The opening of a medical center of this level was a gift to the obstetric care system of the Altai Territory - at the time of the beginning of the work of "DAR" the bed fund in the region had already begun to be restructured. And therefore, the new perinatal center of federal significance took responsibility for the necessary assistance to pregnant women, women in labor, parturient women and newborns in the region during the difficult initial period of reform.
The priority direction of the work of the perinatal center is the use of high technologies, which allow nursing premature babies, including those with extremely low body weight. As the head doctor of the center Irina Molchanova said, the perinatal center is able to perform this task of state importance. The total area of the regional perinatal center is 34 thousand square meters, on which 5,200 units of medical equipment are located, and it allows solving the most serious problems in obstetrics, gynecology and neonatology. The 24-hour hospital is designed for 190 beds, the polyclinic for 120 visits with work in two shifts.
“Most of the patients come from the Altai Territory and the nearby Republic of Altai, but there was one case when a pregnant woman from Barnaul specially flew to give birth from Moscow to us,” says Irina Vladimirovna. “And thanks to video communication, specialists of 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 introduced into practice the method of remote counseling, an external anesthesia and resuscitation obstetric team is working around the clock to provide medical care to critically ill patients from remote areas of the Altai Territory.
As for the increasingly popular method of remote consultation, according to the specialists of the DAR center, the infrastructure of the institution and the network created in the region allow for telemedicine and monitoring sessions by the perinatal birth center in institutions of the Altai Territory.
“Doctors keep a record of each patient’s pregnancy. All information is available to the staff of the perinatal center. Having studied the data on the patient's health, 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 such patients in the region who are remotely monitored not only by specialists of the regional perinatal center "DAR", but also by doctors of federal medical institutions. This happens in particularly difficult cases.
Another feature of the work of the DAR perinatal center is family orientation. Partner childbirth, close to their physiological course, creating a family atmosphere and a comfortable stay, the use of modern methods of pain relief, as well as the use of the latest perinatal technologies: from latching a newborn to the breast at his request and examining the baby in the ward in front of the postpartum woman to early discharge - on 3-4 days. According to Irina Molchanova, strict adherence to technologies that correspond to the modern development of midwifery 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 in the territory of a pine forest. “Within the framework of the cluster, there is interaction with the Altai Regional Oncological Dispensary, the Regional Clinical Hospital. Patients are referred to the regional hospital if there is a need to observe them in a multidisciplinary hospital. From time to time we invite narrow specialists for consultations if a pregnant woman has an exacerbation of somatic diseases, ”explains Irina Vladimirovna.
She said that a specialized department for pregnant women with diabetes is being formed at the DAR perinatal center. The decision was taken 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 accumulate in a third-level facility, as they require special attention from obstetricians-gynecologists, endocrinologists and neonatologists. This is a new direction in obstetrics, which does not work in all regions of Russia yet.
Despite the fact that the average age of doctors is 37 years old, it is relatively young, it includes representatives of higher educational institutions and doctors engaged in scientific work. A number of specialists underwent advanced training and residency at metropolitan universities, 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 the Department of Obstetrics and Gynecology with the course of DPO "Altai State Medical University", where practical classes for students and joint research work are conducted.
2980Photo by Evgeny NALIMOV On March 1, State Duma deputies Daniil Bessarabov and Nikolai Gerasimenko visited the DAR perinatal center to determine its readiness for work. Chief physician Irina Molchanova showed all the structural divisions of the center, which, as promised earlier, are already ready for work. For example, a fully equipped laboratory is located on the fifth floor. At the time of the visit of the deputies, a chromosomal analysis was carried out in one of its blocks, which makes it possible to identify fetal pathologies in the early stages of pregnancy. The fourth floor will soon become a permanent site for a family health and reproduction center, better known as an IVF center. At the moment, 1250 children were born in the Altai Territory with the help of the center's specialists. Currently, 1200 IVF procedures are carried out in the region per year. This volume allows you to fully meet the needs of couples with infertility problems. However, specialists 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 joint stay of the mother and child, if the baby does not have serious pathologies that require specialized care. The individual wards have everything you need for a convenient and comfortable stay and care for your baby and mother. Even feeding will be organized directly in the wards. This will avoid unnecessary contacts, as well as the spread of nosocomial infection, which is most dangerous for newborns. Convenient large washbasin with a movable shower will allow you to maintain the hygiene of the newborn without any problems. As explained by the Minister of Health of the Altai Territory Irina Dolgova, equipment and medical furniture in the wards of domestic production. All this is of very high quality and has the appropriate certificates. Also in the same department there is an intensive care unit for newborns. In these wards, short-term treatment is carried out, that is, literally on the first day. Therefore, mothers are not there around the clock, but they can visit the baby. The rest of the time, supervision and care is carried out by a nurse. In total, we have two such wards with three beds and two separate boxes - for a total of 8 people, - said the postpartum department. Operating rooms are also almost ready. As Irina Molchanova emphasized, the center, including operating rooms, provides for the most contactless methods. You can even open the door to the operating room without touching it - special sensors work. Today, neonatologists will not touch a 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, born prematurely or with any pathology, survive. At the moment, it is known that the biggest carrier of infection is the hands, she said. - And we observe this principle in everything. During the visit, Nikolai Gerasimenko and Daniil Bessarabov talked with patients and medical staff of the center, appreciated its high organization and comprehensive approach to solving any problems. The next day, as part of a special commission, the 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 "Healthy Future" federal project of the United Russia party. One of its directions is control over the implementation of the construction of perinatal centers throughout Russia. Therefore, it was important for me to see with my own eyes what is happening here. Now I can say that I am shocked by the organization of the work of the center. Altai Perinatal Center is the largest of those 32 that are being built throughout Russia. Its 190 beds and the capacity of the perinatal center on Popova provide a powerful potential for reducing infant and maternal mortality. It is impossible that assessments of medical institutions were given by amateurs. Specialists from Roszdravnadzor and Rospotrebnadzor work with the center, who objectively evaluate everything. I can say for sure that the DAR center deserves the highest praise. 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. It employs professionals who have been trained in leading clinics in the country and have extensive experience of their own. 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, which means a high degree of trust in specialists. Any enterprise needs time to reach its planned capacity, for all processes to work normally. The perinatal center, as a new institution, has just begun its work, and you need to help it get back on its feet, form a team, build work on the edge and then move forward with confident steps. Valery Elykomov, doctor, member of the State Duma Committee on Health Protection: Today we watched the new perinatal center for two and a half hours. Today it is a working structure for those types of licensed activities for which it currently accepts patients. Monitoring pregnant women, the possibility of taking them here and the readiness of all services and bases to work in emergency conditions. It is also important that in the perinatal center newborns can be observed, if necessary, up to three months. As a former chief physician of several medical institutions, I can say that a large structure cannot be launched with a wave of a magic wand. I remember well the opening of the regional clinical hospital - at first only 40 beds, then 270, then 870, and today - 1265. But we have not yet had such institutions as the DAR center. Women should know that in our region there are enough forces, means and qualifications to save the lives of mothers and children, if necessary.
Opinions
There was a rumor in Barnaul that women were being taken to the new perinatal center "Dar" on the mountain to give birth without appropriate evidence. In particular, they say that they send patients there from the Barnaul maternity hospital №2, who have no risks and complications.
Why is this needed? Perhaps for show. Some suggest that they cannot yet take a difficult childbirth in an unfinished building - there are no necessary conditions and equipment. But the usual 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 for a comment to the chief physician of Maternity Hospital No. 2 Lyudmila Ananyina.
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 and diagnostic department. They leave someone with them, and who are sent back to us. It all depends on the degree of risk. To themselves, they leave a high-risk group. Everything is regulated by the orders of the regional Ministry of Health, all of them are carried out. There are no pitfalls here.
The doctor found it difficult to name the exact number of women in labor who remained in the perinatal center. But she noted that these are "not such large flows." But consultations, according to her, are received by many women.
The conditions in the center are now excellent. I was there personally and I can say it, - said Lyudmila Ananyina.
A secure facility?
Meanwhile, the other day a story about "Dar" was aired on the NTV channel. The capital's journalists assure that the conditions are far from perfect. The object resembles a security one - with cameras they were allowed only to the first floor (explaining that the quarantine is in effect due to colds). And on the floor above there was a construction site.
Now in the building somewhere there is simply no decoration, somewhere partitions and floors. The design capacity of the center is 190 beds, but 39 are occupied so far. Since the opening, on December 22, only seven children have been born here! - says the plot.
And as official statistics says, on average, about 75-79 children are born in the region per day (in Barnaul - 25-29). And there are quite a few expectant mothers who are at risk and have indications for childbirth in the 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. It remains to wait for a response from officials.
Food for thought
In general, the federal program for the construction of perinatal centers in the country should include 32 such healthcare institutions. The construction of the facilities began in 2013 and should have been completed in the past. In case of default, the regions must return the money allocated for the construction of the centers.
By the end of 2016, 15 out of 32 centers were commissioned. Including the Altai "DAR", which officially opened, but in fact it was just for show, since construction work is still in full swing there, and patients are accepted so far only on one of the four floors of the center.
Taking into account the situation of the regions lagging behind the schedule, at the end of December 2016, Prime Minister Dmitry Medvedev asked the governors to "accelerate" and gave a delay on the delivery of facilities until the end of 2017.
It can be assumed that the deadlines were not postponed accidentally - so that fully completed facilities could be properly completed, equipped and put into operation. What prevented the regional authorities from doing this? The unfinished 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 are there so many different gossip and omissions around the center? It would seem that there is nothing to hide, because the center is in full view of everyone! Have you commissioned an unfinished object? This is how we need to explain to people - we are working further according to the schedule, in the end everything will certainly be at the highest level. To tell as it is - without tricks and secrets, without demonstrating a grandiose discovery and childbirth, which are popularly dubbed "indicative". As a result, we have what we have - the situation gave rise to a lot of negative rumors and spoiled the reputation of the invaluable "Gift".
Help KP
The Dar center (its area is 34 thousand square meters) is being built within the framework of the federal program for the construction of perinatal centers. 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 a new step in obstetrics. There has never been a maternity hospital or perinatal center of such a high level in the region. 3 billion rubles were spent on the construction of Dara. It is planned that departments of gynecology, pathology of pregnant women, pathology of newborns and premature babies, a center for prenatal diagnostics, resuscitation, an IVF center and much more will work here. It is assumed that patients will be able to receive state-of-the-art medical care here.
In the Altai perinatal center "DAR" all the planned departments have been put into operation: gynecological, childbirth, postnatal, departments of pregnancy pathology and newborn pathology, and an obstetric hospital. More than 30 babies have already been born here. Patients are also consulted by doctors from the entire mountain cluster, and it has seven medical institutions at once.
On Skype - a hospital in Shelabolikh. 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 in the perinatal center. She came to "DAR" twice for pregnancy: she has a thyroid gland pathology.
As Svetlana Teplukhina, obstetrician-gynecologist of the perinatal center, explained, “it can be any pathology: we have pregnant women with hypertension, bronchial asthma, and other severe extragenital pathologies. shown ".
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. When diagnosed when pregnancy is contraindicated, the woman risked carrying the baby, now she goes to hemodialysis every day. In Russia, there are cases of successful childbirth with this diagnosis: in Irkutsk and Orenburg. In Barnaul, they took up a difficult case, but warned the woman about another possible outcome.
Tatyana, a patient of the perinatal center, shared: in general, they told me that getting pregnant ... Not that it is contraindicated, but here it happened, and my husband and I decided to keep the pregnancy. What if everything will be all right? What if everything works out?
As the director of the Barnaul Dialysis Center Elena Draganik says, "the management of such patients is very difficult, it is both joint meetings and with gynecologists. This is a great joint work of doctors for 9 months." For the sake of great work in the name of life, the perinatal center "DAR" was built. In the world and in the region, the leading positions in the structure of maternal mortality are occupied by somatic pathologies - this is when, against the background of pregnancy, chronic diseases in women are exacerbated. The Altai Territory is now ready to resist this negative trend.
And such a "thin line of management of such patients, it can only be implemented 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 a healthy baby," Irina Molchanova is sure , chief physician of the DAR perinatal center.
Meanwhile, the Barnaul authorities announced a competition to develop a project for the improvement of the territory of the medical cluster. For this, 3.5 million rubles are allocated from the city budget. And the work itself was promised to be financed by the regional government. The exact amounts will be announced after the development of the project. So, next to the Dar perinatal center, the road will be widened, several parking lots and additional traffic lights will be installed. Landscaping should begin in the summer.
It is also planned to equip a recreation area with benches and walking paths on the site between the Dar perinatal center and the Federal Traumatology Center. In addition, the city authorities want to install additional traffic lights on the Zmeinogorsky tract near the Dynamo ski base. Now it is difficult to travel there, including for ambulances.
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