Organization of medical care for newborns with congenital malformations in the Moscow Region

Abstract

Infant deaths like a litmus paper reflects the level of development of the medical care in the country. The active development of this industry in general and pediatric medicine in particular made it possible to reduce this indicator significantly, but its structure has changed. Now the contribution of congenital malformations has become more significant than 10–15 and even 40 years ago. New reality provides new challenges to the professional community in medical terms as much as in organizational and legislative terms. We present the current system of organizing care for children with congenital malformations, implemented in the Moscow Region, which includes obstetric service (screening for malformations, expert examination and prenatal counseling, delivery in a specialized perinatal center), neonatal, pediatric surgical (prenatal counseling, surgical care in the delivery room, correction of malformations in the neonatal period, subsequent staged treatment and observation) and pediatric services (follow-up observation). The proposed algorithm is aimed at reducing the likelihood of a child being born with an undiagnosed or lethal defect, preventing the uncontrolled development of a critical condition, and providing the most optimal and safe method of surgical treatment and postoperative management tactics. The introduction of such a system will not only reduce infant mortality, but also reduce the disability of the child population.