Resolution the 20th Anniversary of the All-Russian Scientific and Educational Forum “Mother and Child”

The XXth Anniversary All-Russia Scientific and Educational Forum ‘‘Mother and Child’’ was held in Moscow on September 25-27, 2019.

The representatives of one of the most responsible and essential medical professions gathered in Moscow for the 20th time to take part in the Forum. The First Forum, held in 1999, was attended by over than 450 participants. Twenty years later the interest in the Forum boomed by times. This is an evidence of the significance, acknowledgement and high credit of the practitioners to the Forum.

The presentability of the leading domestic and foreign experts whose authority is beyond question, trending topics of the reports, unique multi-format and multi-disciplinary atmosphere – this is the eternal formula for success of the Forum.

Scientific program of the Forum enlarged impressively and this time it included more than 600 reports presented during more than 100 plenary and parallel sessions, round-table conferences, seminars, scientific schools, master classes, panel discussions and training courses.

According to the official statistics, the Forum was attended by 4.433 doctors from 80 territorial entities of the Russian Federation, 318 cities and towns, as well as from 19 near and far-abroad countries (Argentina, Armenia, Azerbaijan, Belarus, Belgium, France, Germany, Great Britain, Hungary, Israel, Kazakhstan, Kyrgyzstan, Lebanon, Moldova, Mongolia, Norway, the USA, Ukraine, Uzbekistan).

The organizers of the Forum are the Ministry of Healthcare of the Russian Federation, V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Russian Society of Obstetricians and Gynecologists (RSOG), League of Midwives of Russia.

G.T. Sukhikh, the Director of the Kulakov Centre, opened the Forum by announcing its ambitious program and noting the scientific potentials of the Kulakov Centre in organizing fundamental and supplementary research studies and educational activities. G.T. Sukhikh also gave the statistical data on unique organ-saving surgeries in patients with various pathological maternal and fetal states, including gynecologicalal oncology in reproductive system. He stated the purposes of the Kulakov Centre among which are cooperation with regional medical organizations, evaluation criteria and problem-solving of the professional competence, as well as the professional accreditation of obstetricians and gynecologists in 2020. The Director also pointed out scientific progress of the Centre in the fields of tissue engineering, cell and ART technologies and etc. Besides G.T. Sukhikh marked the role of RSOG in the process of continuous education of obstetricians and gynecologists, as well as in elaborating of clinical standards and recommendations for medical care delivery, and, finally, outlined the importance of the protection of rights of medical workers together with the National Medical Chamber.

S.A. Tsyb, the First Deputy Minister of the Ministry of Industry and Trade of the Russian Federation greeted the participants of the Forum with the opening address. He also read the welcoming telegram from the Minister of Industry and Trade of the Russian Federation D. V. Manturov. S.A. Tsyb emphasized the significance of the long-term (up to the year of 2024) partnership between the Ministry and the Kulakov Centre in view of child healthcare national programs. He remarked as well the active participation of the Center in the opening of perinatal centers and providing them with hospital facilities, and in production of various pharmaceutical forms for children.

E.N. Baybarina, the Director of the Department of healthcare delivery for children and maternity obstetric service of the Ministry of Healthcare of the Russian Federation, summed up the first results of the implementation of the following National projects: “Healthcare” and “Demography”. She presented the main purpose and the structure of the projects, detailed the achievements of the healthcare system for mother and child, where she as well reported substantial changes. In 2018 in 44 regions of Russia neonatal death indices were below average – 5.1 of 1000 newborns alive. These results were gained owing to the widespread Presidential program aimed at building of perinatal centers and their integration into the three-level maternity obstetric service system. There are 94 perinatal centers in Russia nowadays. Apart from this E.N. Baybarina highlighted the structure of the financial support to the national projects, the availability of the medical care delivery to the hard-to-reach area, the need of the population in medical care delivery service, the out-patient hospitals work perfecting, the issues of the Kulakov Center development, child healthcare, the results of cardio-vascular diseases treatment federal project, the results of the off-site trainings on the territory of the regions of Russia, the problems of the organizing of the mobile primary healthcare delivery system, the improving of the level of informatization in the field of healthcare, and the development of the integrated digital net both for doctors and patients.

Prof. Aris Papageorghiou, Director of clinical research (OMPHI) & Associate Professor (St. George’s Hospital, University of London), presented the report on the role of ultrasound scan in the modern obstetrics based on the international practices. Non-sufficient standardization of the education in the field of ultrasound scan in obstetrics and gynecology was addressed as the major problem. As an illustration the Basic Training Course by the International Society of Ultrasound in Obstetrics & Gynecology (ISUOG) was taken. Prof. Papageorghiou pointed out the significance of sonography training in order to reach the optimal standards for healthcare delivery. In addition he offered to enlarge educational standards of the obstetrician and gynecologist with special chapters on basic skills of ultrasound scan in those clinical states which do not need expert judgment.

In the context of the Forum the following events also came about: National Research and Educational Echographic Congress under the support of ISUOG ‘’Ultrasound scan in obstetrics, gynecology and perinatology – from the first trimester to the healthy newborn’’; IXth research-to-practice conference – ‘’Habitual miscarriage: social problem, medical solutions’’; five pre-courses on complications during perinatal period, inflammatory and infectious diseases in neonatology, cervix uterine and vulvar disorders, strategy and tactics of ultrasound scan of fetus development malformations in the first trimester; aesthetic gynecology; and two post-courses on neonatal cardiology and MRI in obstetrics; head specialists’ meeting; young scientists’ contest.

Scientific program of the Forum comprised the most challenging issues in obstetrics, gynecology and neonatology: treatment policy under medical emergencies in obstetrics; premature delivery; habitual miscarriage; preeclampsia prevention and treatment; unsolved problems of gynecological oncology; mammary glands pathology; basic and clinical matters of endometriosis, uterine miomas and endometrial hyperplasia, inflammatory and infectious diseases of the female reproductive system, new technologies in surgical gynecology, new technologies in reproductive medicine, extragenital diseases, modern possibilities of pelvic floor dysfunction treatment, contraception, pediatric gynecology, wide range of neonatology issues, medical rehabilitation, andrology, prospects for the development of obstetrical and gynecologicalal care delivery in Russia.

The speakers of the plenary session “Prospects for the Development of Reproductive Medicine” (chairpersons: RAS academician G.T. Sukhikh, RAS academician L.V. Adamyan, RAS academician V.N. Serov, academician L.A. Ashrafyan, RAS corresponding member A.D. Makatsaria, RAS corresponding member V.I. Kiselev, prof. V.N. Prilepskaya) discussed the basic problems of the modern family reproductive function implementation; fundamentals of the malignant processes in female reproductive system; measures for saving the reproductive health and family planning in order to enhance the demographic situation in Russia; reproductive system pathology issues.

At the plenary session «Implementation of national and state projects: ways to success» the participants touched upon the most topical problems on the quality assessment of the healthcare delivery service on the territorial entities of the Russian Federation. They also marked the role of the Kulakov Centre in stimulating the potentials of the specialists working in the Centre, as well as the introduction of mild technologies within the specialists’ working fields (chairmen: RAS academician G.T. Sukhikh, D.V. Selivanov, P.h.D. M.P. Shuvalova, prof. N.V. Dolgushina).

The interest demonstrated to the parallel session «C-section surgery in the age of perinatal obstetrics», acknowledged the importance of this topic among practitioners. The session included reports on: the place of c-section surgery when choosing the tactics for childbirth, the influence of the c-section on the decrease of maternity and perinatal mortality frequency rates, uterine scar deliveries, contraindications to c-section, anesthetization methods, preventive antibiotics, postsurgical period management (chairmen: RAS corresponding member I.V. Ignatko, prof. O.G. Pekarev, prof. V.F. Bezhenar, prof. A.I. Istchenko, prof. L.S. Logutova, prof. O.R. Baev, prof. I.A. Salov).

Under the chairmanship of RAS academician G.M. Savelieva, RAS corresponding member V.E. Radzinskiy, prof. Z.S. Khodzhaeva, prof. L.D. Belotserkovtseva the plenary session «Perinatology: modern challenges» was held. Its reports were dedicated to the major problems of nowadays obstetrics, including perinatal death, preterm delivery, mature newborns’ diseases, ART efficiency, indications for periconceptional multivitamin supplementation, c-section frequency reduction and other perinatological issues.

The most acute questions of critical conditions and emergencies in patients were raised during the parallel session «Intensive therapy of life-threatening conditions in obstetrics». The session was held under the chairmanship of RAS academician A.N. Strizhakov, RAS corresponding member I.V. Ignatko, MD A.V. Pyregov. The participants paid special attention to the multidisciplinary approach of the management of pregnant women with multiple organ failure. They discussed modern preventive and diagnostic methods and techniques that could be introduced into the everyday practice of the intensivist or the obstetrician and gynecologist. Treatment tactics in obstetrical patients under various critical conditions and emergencies were as well talked around.

At the parallel session «System of obstetrics: Russian and international experience» the speakers had a discussion over current issues of obstetrical and gynecological care delivery aimed at the reduction of infant and maternal mortality rates (chairmen: prof. O.S. Filippov, prof. A.I. Malyshkina, MD G.B. Malgina, prof. N.V. Bashmakova, prof. T.E. Belokrinitskaya, prof. V.A. Krutova, prof. N.V. Protopopova, prof. I.I. Kukarskaya, prof. L.D. Belotserkovtseva, prof. I.A. Salov)

The reports read at the parallel session «Fetal Surgery: achievements and perspectives» demonstrated the results of surgical correction of spina bifida and other congenital fetal malformations as well as antenatal correction of fetal hydrocephaly. The participants of the discussion also touched upon the treatment of non-immune hydrops fetalis and fetal arrhythmia (chairmen: RAS academician M.A. Kurtser, RAS prof. R.G. Shmakov, M.D N.K. Tetruashvili, MD E.L. Bokeriya).

The main subject of the seminar «Trombophilia in obstetrical and gynecologicalal practice» was the maintenance of current knowledge about the morphological pattern, clinical and laboratory characteristics, modern classification, diagnostic criteria and treatment principles of trombophilia and other tromboembolic disorders in obstetrics (chairmen: RAS corresponding member A.D. Makatsaria, RAS prof. R.G. Shmakov, prof. N.M. Pasman, MD A.V. Pyregov).

Preeclampsia became a traditional topic of the discussion at some parallel sessions. At the plenary session «Preeclampsia: current problems to discuss» (chairmen: RAS academician I.S. Sidorova, RAS corresponding member I.V.  Ignatko, prof. Z.S. Khodzhaeva, prof. I.I. Baranov, prof. L.D. Belotserkovtseva, prof. V.B. Tskhay, MD I.A. Panova) new data on pathogenesis, the possibilities of screening tests, prediction, diagnosis and preeclampsia preventive measures were presented. Apart from this recommendations and management tactics for pregnant patients with severe forms of preeclampsia were discussed. New possibilities for prediction and preeclampsia prevention in pregnant patients from risk groups were also performed. The report made by prof. Z.S. Khodzhaeva and prof. E.L. Yarotskaya brought to the attention of the auditory the results of the pilot project of the International Federation of Gynecology and Obstetrics (FIGО) on screening of preeclampsia in the Ist trimester. The plenary session «Preeclampsia as a multidisciplinary problem: theoretical and clinical aspects» held a discussion of preeclampsia development and its prediction; introduction of special diagnosis methods, intensive monitoring and treatment tactics (chairmen: RAS academician V.I. Krasnopolskiy, prof. V.A. Petrukhin).

The parallel session «Characteristics of modern obstetrics» covered the questions of the development of modern obstetrics, implementation of advanced diagnostic techniques and treatment tactics in obstetrics, and the development of perinatal obstetrics and neonatology service as well as prenatal diagnosis (chairmen: RAS academician V.N. Serov, P.h.D. A.S. Olenev, prof. I.A. Salov, prof. V.V. Kovalev).

«Thrombotic microangiopathy in obstetrics» master class added to the rise of level of practical and theoretical knowledge of the participants which makes it possible to use the algorithms of preventive diagnosis and intensive therapy of such conditions (moderators: prof. T.A. Fedorova, MD A.V. Pyregov).

Current matters of diagnosis and treatment of gestational diabetes were talked about at the seminar «Obstetric and neonatal aspects of gestational diabetes». The participants also discussed habitual miscarriage in women with diabetes (chairmen: prof. Z.S. Khodzhaeva, prof. I.E. Zazerskaya, P.h.D. R.M. Yesayan, P.h.D. R.V.  Kapustin).

Full range of topical issues covering pathological obstetrics was presented at the IX research-to-practice conference on miscarriage (chaired by MD N.K. Tetruashvili).

At the parallel session «Extremely early and early preterm delivery: exchange of experience» the new algorithms of prediction, prevention and management tactics of extremely early and early preterm delivery were demonstrated to the participants (chairmen: MD N.K. Tetruashvili, RAS corresponding member I.V.  gnatko, MD G.B. Malgina, prof. O.R. Baev, prof. Z.S. Khodzhaeva, prof. N.V. Protopopova).

The possibilities for correction and prevention of disorders in patients with multiple pregnancy were covered at the parallel session «Management of complicated multiple pregnancy: results and perspectives». The report on the experience of the Kulakov Centre in surgical treatment of a feto-fetal transfusion syndrome turned out to be of a particular interest for the participants of the session (chairmen: prof. A.V. Mikhailov, MD N.K. Tetruashvili, P.h.D. K.A. Gladkova, P.h.D. K.V. Kostyukov, MD N.V. Kosovtsova).

The opportunity to personify the prevention of trombophilia in pregnant women, the substantiation of anticoagulant therapy in placenta-associated complications, clinical cases of pregnancy management in patients with pulmonary embolism were brought up at the parallel section «Thrombophilic disorders as the predictors of an obstetrical pathology» (chairmen: MD N.K. Tetruashvili, prof. N.M. Pasman). New strategies and tactics for the treatment of fetal anemia, congenital diaphragmatic hernia, fetal hemolytic disease as well as the experience of intrauterine corrections of fetal obstructive uropathy, fetal blood transfusion were demonstrated at the parallel session «Ways and perspectives for fetal therapy» (chairmen: prof. A.G. Konoplyannikov, MD N.K. Tetruashvili). The topics raised at the seminar «Fetus condition disorders: possibilities for diagnosis, perspectives for prevention and treatment» allowed the speakers to evaluate their own knowledge on diagnosis and management tactics for patients with placenta deficiency and fetal growth restriction syndrome; as well as on the assessment and prediction of critical conditions of the fetus using ultrasound scan in the IIIrd trimester of gestation; this seminar also helped the participant to talk around new approaches to the management of pregnant patients with hydrops fetalis, and to discuss the possibilities for fetus antenatal death prevention (chairmen: prof. I.A. Salov, prof. O.R. Baev, P.h.D. A.V. Nikolaeva, prof. R.S.  Zamaleeva, prof. N.N. Rukhlyada, prof. V.V. Kovalev).

New conception of intrauterine infections prevention as well as the possibilities for the prevention of the activation of latent viral infection during the gestation period while introducing periconceptional multivitamin supplementation and the evolution of microbiological technologies were covered at the seminar «Infectious and inflammatory diseases in obstetrics» (chairmen: MD T.V. Priputnevich, prof. A.P. Nikonov, prof. P.V. Budanov).

The speakers of the plenary session dedicated to «Placenta accreta – challenge to perinatal obstetrics» held a discussion on the methods of diagnosis of placenta accreta and surgical tactics for the treatment of such a pathology (chairmen: RAS academician M.A. Kurtser, José M. Palacios-Jaraquemada, RAS prof. R.G. Shmakov, prof. L.D.  Belotserkovtseva, prof. G.A. Penzhoyan).

At the plenary session «Obstetrical hemorrhage: strategy and tactics» the modern principles of prevention and management tactics of major hemorrhage were considered in depth. José M. Palacios–Jaraquemada presented the information on the causes, mechanisms and the nature of disorders of the primary and secondary hemostasis under emergent hemorrhages. He also detailed the treatment algorithms for these disorders (chairmen: José M. Palacios-Jaraquemada, RAS academician M.A. Kurtser, RAS prof. R.G. Shmakov, prof. V.B. Tskhay, prof. A.V. Mikhailov, prof. S.V. Barinov).

New possibilities of prenatal diagnosis were taken into consideration at the parallel session «Prenatal diagnosis: today and tomorrow» (chairmen: Joris Vermeesch, RAS prof. D.Yu. Trofimov, P.h.D. N.V. Zaretskaya). Joris Vermeesch demonstrated to the participants the using of methods of non-invasive prenatal diagnosis in Belgium.

The issues of management tactics of pregnant women with extragenital diseases and the ways to decrease number of complications in such a pathology were covered at the parallel session «Extragenital pathology: periconceptional multivitamin supplementation and pregnancy management» (chairmen: MD N.K. Tetruashvili, prof. Z.S. Khodzhaeva, prof. V.N. Kuzmin, P.h.D. R.M. Esayan, P.h.D. N.I. Klimenchenko).

The presentation of the projects dedicated to the new clinical recommendations in obstetrics and gynecology became one of the most important events at the Forum. The following speakers reported on the topic: prof. N.V. Dolgushina («Habitual pregnancy»), RAS prof. R.G. Shmakov («C-section surgery»), prof. O.R. Baev («Cervix uteri training for the childbirth and labor induction») and P.h.D. V.A. Klimov («Fetus antenatal death»). While holding a discussion, the speakers paid the auditory attention to the complication of presenting the clinical conditions within the sample of clinical recommendations elaborated in the Centre. It was also noted that the results of comparative studies as well as the opinion of the group of experts together with validation results are of high importance.

The problem of endometriosis and uterine miomas were discussed at several seminars and parallel sessions. Apart from this the following issues were touched upon: from molecular and biological mechanisms of pathogenesis and new markers of diseases to the new treatment possibilities. The speakers reported on the current trends in diagnosis and therapy of endometriosis.

The participants of the parallel session «Operative and non-operative gynecology: unity and struggle of opposites» analyzed new techniques in the surgical treatment of gynecological pathology, complications in reconstructive gynecology, understanding the nature of pain in endometriosis and possible ways of its treatment. Also preliminary results in forming the registry of genital malformations were presented (chairmen: RAS academician L.V. Adamyan, RAS corresponding member V.E. Radzinskiy, prof. S.A. Levakov, MD S.V. Yureneva, MD S.A. Martynov).

At the parallel session «Diagnosis and treatment of severe forms of endometriosis: the experience of a General Surgery Department of the Kulakov Centre» the new data on the possibilities for prediction, diagnosis and organ-saving treatment tactics of severe forms of endometriosis were presented to the participants, including complications after surgical treatment of the deep infiltrative endometriosis (chairmen: P.h.D. V.D. Chuprynin, P.h.D. M.V. Melnikov, MD E.G. Khilkevich).

A widespread response to the topics touched upon at the panel discussion «Cervical pathology: from screening to cancer therapy» also covered the issues of the improvement of diagnostic and preventive measures in patients with vaginal infections and cervical disorders; the possibilities for cytokine therapy in order to increase the efficiency of cervical dysplasia treatment. Besides the speakers discussed the multi-target therapy in patients with cervical cancer (moderators: RAS academician L.A. Ashrafyan, RAS corresponding member V.I. Kiselev, RAS prof. N.V. Zarochentseva, prof. Yu. Dondyuk, prof. I.A. Apolikhina).

Research-to-practice conference «Infections in obstetrics and neonatology» under the support of Central Scientific and Research Institute of Epidemiology of Rospotrebnadzor (Federal Supervisory Service for Consumer Rights and Human Welfare) was considered of high importance among the specialists. The speakers posed such questions as: microbiota formation in children, modern ways of prevention, diagnosis and treatment of infections bind to medical care delivery in obstetrics and gynecology; the possibilities for laboratory diagnosis and prevention of toxoplasmosis as well as cytomegalovirus disease in pregnant patients (chairmen: RAS corresponding member A.V. Gorelov, RAS corresponding member A.V. Tutelian).

The speakers of the parallel session «Aesthetic gynecology and urogynecology» presented to the audience the latest data on the new trends in diagnosis and treatment in these fields of medical science. They as well covered the possibilities for combining different treatment methods, the sequence of their implementation and the continuous management of patients (chairmen: prof. I.A. Apolikhina, RAS prof. N.V. Zarochentseva).

Chronic and inflammatory processes in small pelvis organs in obstetrics and gynecology were also mentioned at some of the seminars and round-table conferences.

A round-table conference «HPV-associated diseases: new challenges and monitoring strategies» had a very active discussion on the possibilities of screening tests of HPV-associated diseases, international and domestic experience in the efficiency of vaccinal prevention of HPV-associated diseases (chairmen: RAS academician L.V. Adamyan, RAS academician L.A. Ashrafyan, RAS academician L.C. Namazova-Baranova, prof. V.N. Prilepskaya).

Round-table conference «Pelvic floor pathology: complex approach to choosing the treatment tactics» was aimed at demonstrating modern approaches to the management of women patients with a widespread pelvic pathology. The speakers also talked around the topics of combined treatment, including the methods of pelvic muscles training, urogynecological and obstetrical pessaries, surgical correction of various forms of pelvic prolapse in women (chairmen: prof. A.I. Istchenko, MD T.Yu. Smolnova, prof. G.B. Dikke, prof. E.Yu. Glukhov, prof. V.A. Krutova).

The using of contraceptives, rational hormone therapy of endometrial hyperplastic processes, health and quality of life of women at different ages were as well discussed at the number of parallel sessions, seminars and round-table conferences.

Much attention at the Forum was paid to the discussion of innovative approaches to the prevention and therapy of benign and malignant neoplasms in female reproductive system.

At the parallel session «Oncological diseases and pregnancy» the participants noted the significance of screening programs for early diagnosis of neoplasms in the female reproductive system. In addition to the above mentioned the questions of adequate evaluation of the reproductive potential and the most preferable management tactics for pregnant women with oncology were raised at the session. (chairmen: RAS academician L.A. Ashrafyan, RAS prof. R.G. Shmakov, MD A.A. Parokonnaya, MD S.B. Khokhlova). The parallel session «Topical issues of diagnosis, treatment and rehabilitation of patients with mammary gland pathology» offered the auditory to reason for a while on the early markers of mammary gland oncogenesis, drug therapy and preventive measures, morphological and molecular genetic predictors of mammary gland cancer metastasis into the regional lymph node (chairmen: RAS academician L.A. Ashrafyan, RAS corresponding member V.I. Kiselev, prof. N.I. Rozhkova, MD V.V. Rodionov).

Central problems of neonatology and pediatrics were presented at a large group of parallel sessions, seminars and round-table conferences.

The participants of the plenary session «Neonatology: perspectives for development» held a discussion on the major purposes of neonatal service system, including such as the infant mortality frequency decrease, the analysis of perinatal pathology risk factors in early neonatal period in late preterm newborns (chairmen: prof. D.O. Ivanov, prof. D.N. Degtyarev, MD V.V. Zubkov). Round-table conference «Perinatal cells in neonatology» considered the problems of clinical implementation of perinatal stem cells in various pathological states in newborns (chairmen: RAS academician G.T. Sukhikh, MD V.V. Zubkov, MD D.N. Silachev). At the seminar «Microbiota of newborns: new technologies – a fresh approach» (chairmen: MD V.V. Zubkov, MD T.V. Priputnevich, prof. I.N. Zakharova) the speakers covered the issues of microbiota formation and its influence on the development of various diseases in newborns. In addition to this new data on non-clinical studies of a new probiotic and its further preventive use in the treatment of necrotizing enterocolitis in newborns were presented. The following seminar «Breastfeeding and the features of nutrition support of newborn children» was dedicated to the main difficulties in breastfeeding, modern technologies for its support and encouragement, and also the results of the follow-up study on ART-children (chairmen: prof. I.I. Ryumina, P.h.D. E.V. Grosheva, P.h.D. A.V. Levadnaya). At the round-table conference «Topical questions of neonatology and pediatrics» the speakers discussed the problems of perinatal infections in the structure of neonatal morbidity and mortality, new approaches to the correction of GIT disorders in newborns, the effectiveness of screening tests in newborns with obstructive aortic failure using pulse oximetry and dual-zone measurement of systolic artery pressure (chairmen: P.h.D. M.P. Shuvalova, MD M.V. Narogan, prof. A.V. Degtyareva).

The parallel session «Responsibility of medical workers: current problems» allowed the auditory to get acquainted with the new legislative provisions in forensic medicine among which are: compensation for harm connected with medical care delivery; algorithms of behavior in critical situations; area of responsibility of medical workers (chairmen: A.I. Sazonov, L.A. Aidarova, A.Yu. Chuprova).

Within the framework of Forum the participants also attended: scientific schools in andrology, HIV-associated cervical diseases, hormone contraception; master classes in thrombotic microangiopathy in obstetrics, as well as treatment of vulvar and vaginal infections; debating club on the project “Demography”; clinical lectures of experts, panel discussions, sessions, trainings, symposiums, conferences, working groups’ meetings on the accreditation of medical workers; head specialists’ meeting, coordination meeting of young specialists in obstetrics and gynecology.

Young scientists’ contest was traditionally held in conjunction with the Forum. The contest covered the discussion of the research studies submitted to the contest, and the choosing of the winners (chairman: RAS corresponding member I.V. Ignatko; award panel: prof. I.I. Baranov, MD D.A. Voronov, RAS prof. N.V. Zarochentseva, V.N. Kuzmin).

National Research and Educational Echographic Congress under the support of ISUOG ‘’Ultrasound scan in obstetrics, gynecology and perinatology – from the first trimester to the healthy newborn’’ (chairman: prof. A.I. Gus) was dedicated to the possibilities and perspectives of the implementation of the most trending methods of ultrasound scan in obstetrics and gynecology. New ultrasound technologies were demonstrated as well: screening techniques in prediction of the great obstetrical syndromes; 2D and 3D/4D sonography in obstetrics and gynecology; new principles of the evaluation of the fetus functional status. Special attention was paid to the mastering of doctors’ skills in ultrasound scanning in neonatology. The leading national and foreign experts attended the event. For the first time, the educational modules of the ISUOG Basic Training Course “Identifying the normal and abnormal pregnancy” were demonstrated to the Russian audience.

The scope of the topics presented at the Forum was impressively wide. The scientific program covered all the professional interests of all the obstetrical and gynecological specialities.

Despite the results obtained, there is still number of problems unsolved: extragenital abnormalities that take the leading place in maternal morbidity and mortality rates; the health decline in female reproductive system; the growth of malignant neoplasms in female reproductive system.

In view of the discussion, the participants of the XX All-Russia Scientific Forum «Mother and Child» believe it is necessary to recommend the following:

• To continue active work on elaborating and implementation of the clinical recommendations and protocols on the most acute problems in obstetrics, gynecology and neonatology according to the standards of the Ministry of Healthcare of Russia.
• To increase the work on the implementation of periconceptional multivitamin supplementation and pregnancy planning in women with extragenital diseases.
• To prioritize the decrease of c-section frequency rate by taking into account the following recommendations: strict regulation of the indications for c-section surgery; the use of modern methods to prepare women for vaginal birth after c-section.
• To expand the use of spinal anesthesia, blood reinfusion and polyplasmia in c-section. To improve the preventive measures of infectious complications in c-section.
• To continue the advancement of organ-saving surgeries in placenta accreta, obstetrical hemorrhages, peritonitis after c-section.
• To activate the work on implementation of the methods of non-invasive prenatal diagnosis.
• To expand the practice of emergency care delivery to the fetus, especially in multifetal monochorionic pregnancy.
• To give veracious information on perinatal losses. The number and frequency of still births and neonatal deaths enable to elaborate on the improving of preventive measures.
• To pay special attention to the development of reasonable recommendations on the prevention of preterm delivery.
• To develop the system of external and internal clinical audit in neonatology in order to improve the quality of medical care delivery to the newborns.
• To expand the scientific and research interdisciplinary approach to solve the problems of gynecological oncology and obstetrics.
• To strengthen the work on the improvement of level of doctors’ competence in order to enhance the quality of medical care delivery and to reduce the maternal and perinatal morbidity and mortality frequency rates.
• To prioritize the development of work of the primary stage in obstetrical and gynecological care delivery system – maternity welfare centers.
• To take part together with the National Medical Chamber in elaborating measures for the protection of the rights of medical workers.
• To expand the practice of pre-court proceeding in clinical practice of regional societies of obstetricians and gynecologists.
• To continue the preparation of revised editions of the clinical guidelines in obstetrics and gynecology, neonatology, allowing the doctors to improve their work in these fields.
• To develop the methods of continuous medical education. To approve of the work of Regional educational RSOG schools and to recommend their further development.
• To encourage the use of the possibilities of universities’ departments, scientific organizations and perinatal centers in the work of the Akusherstvo i Ginekologia (Obstetrics and gynecology) journal.
• To continue holding annual forums.

Discussed and approved at the XXth Anniversary All-Russia scientific and educational forum ‘‘Mother and Child’’ on September 27, 2019.

Head of the Forum, RAS academician G.T. Sukhikh
RSOG President, RAS academician V.N. Serov