DEVELOPMENT OF PERINATAL MEDICINE IN UKRAINE IN THE CONTEXT OF INTERNATIONAL APPROACHES

Abstract

The aim: To realize analysis and assessment of completeness and efficacy in the field of perinatal aid regionalization in Ukraine. Materials and methods: A retrospective analysis has been carried out as well as assessment of inculcation steps concerning regionalization of perinatal health care in Ukraine according to the data of state and branch statistics and monitoring (in 2013-2017). The methods used here are systemic approach, bibliography method, and statistical data evaluation. Conclusions: It is shown the modern globally acknowledged three-level system of perinatal health care has been organized and functions in Ukraine, perinatal tertiary level centers are now act in the majority of regions. The perinatal health care realization during these last years is shown to be able to assure the providing of adequate perinatal aid taking into consideration the calculated data concerning the pregnant women concentration with high perinatal risks in third level institutions; these patients include pregnant women with heart defects (63.2-69.9%), circulatory system defects (48.5-50.5%), diabetes mellitus (46.7-53.3%); in institutions of the second-third levels, there are 74.2-83.0% of patients with severe gestoses. According to functional possibilities of perinatal aid institutions of different levels, they assure 62%-64.5% of births with body mass 500-999 g and 53.9%-55.3% of ones with body mass 1000-1499 g in perinatal clinics of the third level; it guarantees the survival of newborn babies with body mass 500-999 g and 1000-1499 g during their first 168 h reaching 60.1-65.1% and 89.4%-90.4%, respectively. Efficacy of perinatal aid regionalization is confirmed by a positive tendency of perinatal mortality index; it has become significantly lower: in 2010, the perinatal mortality reached 10.54 cases per 1,000 of newborn alive and dead babies, this index having dropped to 8.89 in 2019. The maternal mortality levels have also decreased from 23.5 up to 14.9 cases per 100,000 of babies born alive. Perinatal aid regionalization in Ukraine is being realized according to international strategies permitting to provide effective perinatal aid to patients at each level of its provision depending on patient's need.