Features of modern obstetrics
The paper shows the changes that have determined the features of modern obstetrics. A sharp decline in birth rates and the elements of depopulation in the country have created new conditions for reforming healthcare and modern obstetrics. Each pregnancy and each child have acquired a special value. In the country, prenatal diagnosis has been introduced and neonatology has evolved. The obstetric strategy has become more active; surgical delivery has increased significantly. Caesarean sections are performed 8—10 times more often. The intensive care and rehabilitation ofpremature and sick newborns are being actively improved. Maternal and infant mortalities have decreased by 8—10 and 5—6 times, respectively. However, there have been new problems: an increase in the number of bleedings due to placenta previa and placenta increta in pregnant women who have undergone a caesarean section. Antibiotics have become less effective; the number ofpostpartum infectious diseases has increased. More and more babies are being born premature. The role of extragenital diseases in obstetric pathology has increased; this is especially clearly manifested during the coronavirus pandemic. Treatmentfor infertility has been improved; assisted reproductive technologies, including in vitro fertilization, are being actively developed. In recent years, much has been done to improve and develop the foundation of obstetrics; 93 perinatal centers are functioning, all obstetric facilities have been provided with modern diagnostic and medical equipment.Serov V.N., Nesterova L.A.
Conclusion: Modern obstetrics has a perinatal direction. Obstetricians are actively involved in solving the demographic problems facing the country. Modern obstetric strategies can reduce maternal and infant morbidity and mortality.
Keywords
modern obstetrics
maternal and infant mortality
perinatal centers
References
1. Курашвили В.И., Абрамченко В.В., Баев О.Р. Оперативное родоразрешение в современном акушерстве. СПб.; 2016. [Kurashvili V.I., Abramchenko V.V., Baev O.R. Operative delivery in modern obstetrics. St Petersburg; 2016. (in Russian)].
2. Цхай В.Б., Леванова Е.А. Возможность применения органосберегающей тактики у пациенток с маткой Кувелера. Акушерство и гинекология. 2021;8: 200-5. [Tskhai V.B., Levanova E.A. The possibility of using organ-sparing tactics in patients with a Couvelaire uterus. Obstetrics and Gynecology. 2021; 8: 200-5. (in Russian)]. https://dx.doi.org/10.18565/aig.2021.8.200-205.
3. Ральникова А.Ю., Беженарь В.Ф., Аракелян Б.В., Линде В.А., Габелова К.А., Молчанов О.Л. Успешное органосохраняющее хирургическое лечение у пациентки с врастанием предлежащей плаценты в область рубца на матке. Акушерство и гинекология. 2020; 2: 183-9. [Ralnikova A.Yu., Bezhenar V.F., Arakelyan B.V., Linde V.A., Gabelova K.A., Molchanov O.L. Successful organsparing surgical treatment in a patient with the placenta previa growing into the uterine scar region. Obstetrics and Gynecology. 2020; 2: 183-9. (in Russian)]. https://dx.doi.org/10.18565/aig.2020.2.183-189.
4. Макацария А.Д., Бицадзе В.О., Хизроева Д.Х., Акиньшина С.В. Тромботические микроангиопатии в акушерской практике. М.: ГЭОТАР- Медиа; 2017. 304c. [Makatsariya A.D., Bitsadze V.O., Khizroeva D.Kh., Akin’shina S.V. Tromboticheskie mikroangiopatii v akusherskoy praktike/ Thrombotic microangiopathies in obstetric practice. Moscow: GEOTARMedia; 2017. 304 p. (in Russian)].
5. Забелина Т.М., Васильченко О.Н., Шмаков Р.Г., Пирогова М.М., Каримова Г.Н., Чупрынин В.Д., Щеголев А.И., Ежова Л.С., Гус А.И., Бойкова Ю.В., Быченко В.Г., Учеваткина П.В. Эффективность комплексного компрессионного гемостаза при различных степенях врастания плаценты. Акушерство и гинекология. 2020; 6: 30-6. [Zabelina T.M., Vasil'chenko O.N., Shmakov R.G., Pirogova M.M., Karimova G.N., Chuprynin V.D., Shchegolev A.I., Ezhova L.S., Gus A.I., Boikova Yu.V., Bychenko V.G., Uchevatkina P.V. The effectiveness of complex compression hemostasis in treating different grades of the placenta accreta spectrum disorders. Obstetrics and Gynecology. 2020; 6: 30-6. (in Russian)]. https://dx.doi. org/10.18565/aig.2020.6.30-36.
6. Morlando M., Sarno L., Napolitano R., Capone A., Tessitore G., Maruotti G., Martinelli P. Placenta accreta: Incidence and risk factors in an area with a particularly high rate of cesarean section. Acta Obstet. Gynecol. Scand. 2013; 92(4): 457-60. https://dx.doi.org/10.1111/aogs.12080.
7. Шмаков Р.Г., Пирогова М.М., Васильченко О.Н., Чупрынин В.Д., Ежова Л.С. Хирургическая тактика при врастании плаценты с различной глубиной инвазии. Акушерство и гинекология. 2020; 1: 78-82. [Shmakov R.G., Pirogova M.M., Vasilchenko O.N., Chuprynin V.D., Ezhova L.S. Surgery tactics for placenta increta with different depths of invasion. Obstetrics and Gynecology. 2020; 1: 78-82. (in Russian)]. https://dx.doi.org/10.18565/ aig.2020.1.78-82.
8. Белобородова Н.В. Проблема сепсиса: поиск новых решений. В кн.: Труды XIX Российского национального конгресса «Человек и лекарство»:
Лекции для практикующих врачей. М.; 2013: 396-405. [Beloborodova N.V. The problem of sepsis: the search for new solutions. Proceedings of the XIX Russian National Congress "Man and Drud". 2013: 396-405. (in Russian)].
9. Венгеров Ю.Я. Сепсис: научная обоснованность и практическая значимость новых концепций диагностики и лечения. В кн.: Труды XVIII Российского национального конгресса «Человек и лекарство»: Лекции для практикующих врачей. М.; 2012: 536-51. [Vengerov Yu.Y. Sepsis: scientific validity and practical significance of new concepts of diagnosis and treatment. Proceedings of the XVIII Russian National Congress "Man and Drug". 2012: 536-51. (in Russian)].
10. Шалина Р.И., Касум-заде Н.К., Коноплянников А.Г., Латышкевич О.А., Шеховцов Д.Б. Прогнозирование и профилактика преэклампсии в условиях городского центра планирования семьи и репродукции. Акушерство и гинекология. 2020; 7: 61-70. [Shalina R.I., Kasum-zade N.K., Konoplyannikov A.G., Latyshkevich O.A., Shekhovtsov D.B. Prediction and prevention of preeclampsia in the city Center for family planning and reproduction. Obstetrics and Gynecology. 2020; 7: 61-70. (in Russian)]. https://dx.doi.org/10.18565/aig.2020.7.61-70.
Received 28.02.2022
Accepted 05.03.2022
About the Authors
Vladimir N. Serov, Dr. Med. Sci., Professor, Academician of the Russian Academy of Sciences, Chief Researcher, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, +7(495)438-72-87, v_serov@oparina4.ru, 4 Oparina str., Moscow, 117997, Russian Federation.Lyudmila A. Nesterova, Senior Researcher, Department of Scientific and Educational Programs, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, +7(495)438-77-44 (ext. 1437), l_nesterova@oparina4.ru, 4 Oparina str., Moscow, 117997, Russian Federation.
Authors’ contributions: Serov V.N. - concept of the review, writing the text, editing; Nesterova L.A. - material collection, writing the text.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The investigation has not been sponsored.
For citation: Serov V.N., Nesterova L.A. Features of modern obstetrics.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 3: 5-11 (in Russian)
https://dx.doi.org/10.18565/aig.2022.3.5-11
Similar Articles
