2019 № 3 Prevalence of socio-biological risk factors in pregnant women of Krasnoyarsk region and their impact on adverse pregnancy outcomes
The aim of the study was to study the prevalence of socio-biological risk factors in pregnant women of the Krasnoyarsk territory and their impact on the risk of adverse pregnancy outcomes. The analysis includes data on 122 250 cases of pregnancy in the period from 2014 to 2017 in the Krasnoyarsk region. All analyzed cases of pregnancy were divided into 2 groups: group I – cases of pregnancy with unfavorable outcomes (8 290 cases), group II – cases of pregnancy with favorable outcomes (113 960 cases). The paper analyzes the following factors: mother’s age less than 18 years or 40 years or more, father’s age 40 years or more, the presence of the mother and father of occupational hazards, bad habits (smoking 1 pack of cigarettes a day, alcohol abuse), mother’s height 158 cm or less, as well as the mother’s body weight 25% higher than normal. To assess the impact of the studied factors on the risk of adverse pregnancy outcomes, the odds ratio was calculated. The results of the study indicate that the presence of occupational hazards in the mother and her age less than 18 years do not affect the risk of adverse pregnancy outcomes. To the greatest extent, this risk is influenced by the presence of bad habits in the mother (smoking and alcohol abuse) and the father (alcohol abuse), as well as the presence of occupational hazards in the father. The use of information on the impact of various factors on the risk of adverse pregnancy outcomes will allow the most effective routing of pregnant women by levels of care to reduce, ultimately, the number of these outcomes. The results show that the risk of adverse pregnancy outcomes is influenced by a fairly wide range of factors. In this case, each factor has a different degree of impact on the risk. Given these circumstances, it is necessary to further develop an integrated assessment of the risk of adverse pregnancy outcomes.
2016 № 1 Incidents of morbidity and outcomes of pregnancy among women in Moscow in the period between 2010 and 2014 years
Analysis of pregnancy outcomes in Moscow in the period between 2010 and 2014 years demonstrated a growth of some pregnancies 9.2%. Whereas there was recorded an increase in the number of abortions by 5.7% and extra-uterine pregnancies by 15.6%. The number of pregnant women with various pathologies has increased from 78.5% (2010) to 80.7% (2014). Wherein the total morbidity rate among pregnant women decreased from 206.41 to 191.65 in 2014, and the forecasted estimate demonstrates a possible growth. There is also a decline in cases of diseases of the genitourinary system by 4.8%, cases of anaemia by 7.6% and blood circulatory system disease by 1.3%. At the same time, there was recorded a growth in the number of venous complications by 5.1% from 5.86 (2010) to 6.16 (2014) per 100 who ended their pregnancy, and growth of endocrine system diseases.
2022 № 8 Organizational and legal issues of examination of minors in a gynecological hospital
The organizational and legal aspects of gynecological care for minors remain a matter of debate, and the indicated topic requires further detailed study. Due to the limited scope of work, not all relevant aspects on the issue under consideration are considered, but only issues of providing information about a minor to law enforcement agencies without the consent of the patient and her legal representative. The relevance of the study is largely due to the fact that the answer to the indicated questions causes difficulties not only among medical professionals, but also among lawyers.
The authors set out to substantiate the main features of the organization of gynecological care for minor patients, as well as provisions for the observance of their rights. To achieve the goal, the authors set the tasks of determining the legal status of minor patients of the gynecological hospital, the accompanying duties of medical workers and medical organizations, development of practical recommendations on the actions of a medical organization when examining a minor and establishing the fact of pregnancy, as well as interaction with law enforcement agencies.
The study materials were the provisions of regulatory legal acts in the field of health protection and ensuring the rights of minors, as well as judicial practice on the issue under study.
When conducting the study, the authors used general scientific and private scientific methods of cognition, such as analysis and synthesis, formal and legal, interpretations.
During the examination of a minor in a gynecological hospital, doctors face the need to ensure the rights of minor patients both to sexual inviolability, sexual freedom and the normal moral and physical development of the minor’s personality, as well as to ensure the protection of personal data and medical secrets. I correspond to these rights the obligations of medical workers and medical organizations not only to transfer information about the patient to law enforcement agencies in cases established by law, but also to comply with the requirements of the law on the protection of information constituting a secret protected by law.
As a result of the study, the authors came to the following conclusions. When establishing the fact of pregnancy of a minor or the entry of a minor into sexual intercourse (other sexual acts), if there are no sufficient grounds to believe that harm to her health was caused as a result of illegal actions, the medical professional (doctor) must explain to the minor (her legal representative) the possibility of transmitting relevant information to the internal affairs body; obtain written consent to the transfer of relevant information to the internal affairs body, which is stored in a medical organization; transfer relevant information to the medical officer responsible for timely informing the internal affairs bodies.
The results of the study can be used by gynecological hospitals and other medical institutions in organizing the provision of gynecological care to minor patients, interaction with the internal affairs bodies to protect the rights and legitimate interests of minors.
2019 № 10 Perinatal monitoring system in Krasnoyarsk region
Successful functioning of information software systems that provide automation of monitoring of pregnant women at the regional level is possible only if there is, as well as continuous improvement of the organizational system. The lack of a well-established organizational system does not allow to use the capabilities of these complexes and often leads to their asynchronous work.
The aim of the study was to form a scheme of perinatal care in the Krasnoyarsk region using the perinatal monitoring system and its evaluation using the methodology of system analysis. Data on 122 250 cases of pregnancy in the period from 2014 to 2017, the degree of risk of women, as well as the outcomes of these cases of pregnancy were used to analyze the work of perinatal monitoring of the Krasnoyarsk territory. All pregnancy outcomes were divided into 2 groups: cases of pregnancy with adverse outcomes and favorable outcomes.
Despite the rather long-term work of perinatal monitoring in the Krasnoyarsk region, the analysis of the existing system revealed a number of significant shortcomings that limit its effectiveness, functioning and management of this system. The lack of management of women’s consultations as the level of management of the system of perinatal care in the Krasnoyarsk region, the imperfection of the system of assessing the degree of perinatal risk, the lack of information in the existing reporting forms and information on the outcomes of completed pregnancy cases in the database of the system were noted as shortcomings.
Identification of the presented shortcomings allowed to form the offers allowing to increase efficiency, to expand opportunities, and also to create tools of management of routing of pregnant women in system of perinatal monitoring.