Эпидемиология преждевременных родов и нюансы медицинской эвакуации в Республике Тыва и Алтайском крае

Abstract

The aim of the research is to assess the epidemiology of premature birth and measures for organizing medical evacuation of patients from agricultural regions in vast territory of the Tyva Republic and Altay Territory for the period 2015-2019. Material and methods. Th e statistical reports data on the work of obstetric service in the Tyva Republic and Altay Territory for the period 2015-2019 are analyzed. Th e frequency, structure, dynamics of premature birth, features of organizing medical evacuation have been studied. Th e analysis of the information received was carried out using absolute, relative and intensive fi gures. Th e statistical signifi cance of the temporal dynamics of data was assessed using regression analysis with calculation of determination coefficient. Results. The analysis showed that premature birth frequency in two agricultural regions with a vast territory and diff erent nationalities in the Tyva Republic and Altay Territory over the past 5 years has no tendency to decrease (2019 – 6.2 % and 7.1 %, respectively) and the data are comparable with an average Russian indicator (2018 - 6.0 %). Distribution of PB by clinical phenotype and gestational age in the studied territories does not diff er and correspond to global indicators. Th e share of very early premature births (22-27 weeks of gestation) is not more than 7 %. A distinctive feature of Altai Territory in comparison with the Tyva Republic is a rarer (p <0.001) obstetric delivery of patients with PB in obstetric hospitals, level III (63.3 % and 96.8 %, respectively), which is associated with high frequency of late PB (53.1 %) and suffi cient capacity of medical organizations, level II. During medical evacuation in the regions, beta-adrenergic agonist ginipral (95 %) was used for acute tocolysis. Conclusion. Organization of medical evacuation in the Tyva Republic is characterized by more frequent use of air ambulance for patient transportation to obstetric hospital, level III, which is explainable by 7 times lower population density compared to Altay Territory with the same schemes of acute tocolysis.