A rumor spread across Barnaul - a new one perinatal center“Dar”, on the mountain, is taken to give birth to women without appropriate indications. In particular, they say that they send there patients from Barnaul maternity hospital No. 2 who do not have any risks or complications.
Why is this necessary? Perhaps for show. Some people assume that they can’t yet have a difficult birth in an unfinished building - no necessary conditions and equipment. But normal childbirth - please. Thus, statistics and indicators are made, justifying huge funding.
Call to the maternity hospital
"Komsomolskaya Pravda - Barnaul" decided to check this rumor and turned to the chief doctor of Maternity Hospital No. 2 for comment Lyudmila Ananina.
Yes, we send women there. But only those who have testimony, everything is as it should be,” Lyudmila Ananyina denied the rumors. - This center officially operates a clinical diagnostic department. They keep some of them, and some they send back to us. It all depends on the degree of risk. They leave themselves a high-risk group. Everything is regulated by the orders of the regional Ministry of Health, everyone follows them. There are no pitfalls here.
The doctor found it difficult to name the exact number of women giving birth who remained in the perinatal center. But she noted that these are “not such large flows.” But, according to her, many women receive consultations there.
Conditions in the center are now excellent. I was there personally and I can confirm this,” Lyudmila Ananyina emphasized.
Regime object?
Meanwhile, the other day a story about “The Gift” was aired on the NTV channel. Capital journalists assure that the conditions are far from excellent. The facility resembles a security facility - they were allowed with cameras only on the first floor (explaining that there was a quarantine in force due to colds). And on the floor above there was construction going on.
Now in some parts of the building there is simply no finishing, in some places there are no partitions or floors. The design capacity of the center is 190 beds, but 39 are occupied so far. Since its opening, on December 22, only seven children have been born here! - the story says.
And as official statistics say, on average about 75-79 children are born per day in the region (in Barnaul - 25-29). And there are quite a lot of expectant mothers who are at risk and have indications for childbirth in a perinatal center. But for what reasons do they not go there?
Many questions remain. To get answers to them, Komsomolskaya Pravda sent a request to the Ministry of Health of the Altai Territory. We can only wait for the officials' response.
Food for thought
In general, the federal program for the construction of perinatal centers in the country should create 32 such health care institutions. Construction of the facilities began in 2013 and should have been completed in the past. In case of failure to fulfill obligations, the regions must return the money allocated for the construction of the centers.
By the end of 2016, out of 32 centers, 15 were commissioned. Including the Altai “DAR”, which, although officially opened, was essentially just for show, since construction work was still in full swing there, and patients were being accepted so far only on one of the four floors of the center.
Considering the situation where regions are lagging behind schedule, at the end of December 2016, Prime Minister Dmitry Medvedev asked governors to “accelerate” and gave a delay in the commissioning of facilities until the end of 2017.
It can be assumed that the deadlines were not postponed by chance - so that fully completed facilities could be properly completed, equipped and put into operation. What prevented the regional authorities from doing this? The unfinished building was hastily opened on December 22, 2016, as if they were being rushed. But there is still a whole year ahead.
And one more question: why is there so much gossip and omissions around the center? It would seem that there is nothing to hide, because the center is in plain sight for everyone! Have you put an unfinished object into production? This is what we need to explain to people: we are continuing to work according to schedule, and in the end everything will definitely be at the highest level. Tell it like it is - without tricks and secrets, without demonstrating a grand discovery and childbirth, which people called “demonstrative”. In the end, we have what we have - the situation gave rise to a lot of negative rumors and spoiled the reputation of the priceless “Dar”.
KP Help
The construction of the Dar center (its area is 34 thousand square meters) is taking place within the framework of the federal program for the construction of perinatal centers. The Altai Territory was included in this program in 2011. The bulk of funds from the federal and regional budgets were invested in 2015 and 2016.
The object is undoubtedly important and necessary. For the Altai Territory, this is a new step in obstetric care. Maternity hospital or perinatal center such high level has not been in the region yet. 3 billion rubles were spent on the construction of Dar. It is planned that there will be departments of gynecology, pathology of pregnant women, pathology of newborns and premature babies, a prenatal diagnostics center, intensive care unit, IVF center and much more. It is expected that patients will be able to receive state-of-the-art medical care here.
Opening medical center this level was a gift to the obstetric system of the Altai Territory - at the time of the start of DAR’s work bed capacity the region has already begun to restructure. And therefore responsibility for necessary help pregnant women, women in labor, postpartum women and newborns in the region for a difficult initial period The new perinatal center of federal significance took over the reform process.
The priority area of work of the perinatal center is the use of high technologies that make it possible to care for premature babies, including those with extremely low body weight. As I told you chief physician center Irina Molchanova, the perinatal center is able to perform this task of national importance with high quality. The total area of the regional perinatal center is 34 thousand. square meters, which houses 5,200 pieces of medical equipment and allows you to solve the most serious problems in obstetrics, gynecology and neonatology. The 24-hour hospital has a capacity of 190 beds, the clinic has a capacity of 120 visits, working in two shifts.
“Mostly patients come from the Altai Territory and the nearby Altai Republic, but there was one case when a pregnant woman originally from Barnaul specially flew from Moscow to give birth to us,” says Irina Vladimirovna. “And thanks to video communication, specialists from the perinatal center conduct online consultations on the management of pregnant women with colleagues from regional hospitals.”
However, despite the fact that the center has developed and put into practice a method of remote consultation, to provide medical care For severely ill patients from remote areas of the Altai Territory, a mobile anesthesiology and resuscitation obstetric team works around the clock.
As for the increasingly popular method of remote consultation, according to specialists from the DAR center, the infrastructure of the institution and the network created in the region allow telemedicine and monitoring sessions to be conducted by the perinatal birth center in institutions of the Altai Territory.
"Doctors are leading account for each patient's pregnancy. All information is available to the staff of the perinatal center. Having studied the data on the patient’s health condition, the doctors of the perinatal center give their recommendations, and, if necessary, invite them to Barnaul for further examination and observation,” explains the head physician of DAR.
According to her, there are also patients in the region who are monitored remotely not only by specialists from the regional perinatal center “DAR”, but also by doctors from federal medical institutions. This happens in particularly difficult cases.
Another feature of the work of the DAR perinatal center is its family orientation. Partner childbirth, close to its physiological course, creating a family atmosphere and a comfortable stay, application modern methods pain relief, as well as the use of the latest perinatal technologies: from putting the newborn to the breast at his request and examining the child in the ward in front of the mother in labor to early discharge - on 3–4 days. According to Irina Molchanova, strict adherence to technologies corresponding to modern development obstetrics is the key to success in the field of obstetrics.
It is also important that the DAR center is part of the Altai medical cluster, located on the territory of a pine forest. “Within the framework of the cluster, there is interaction with the Altai Regional Oncology Dispensary and the Regional Clinical Hospital. Patients are referred to regional hospital, if there is a need to observe them in a multidisciplinary hospital. We periodically invite specialists for consultations if a pregnant woman experiences an exacerbation somatic diseases", explains Irina Vladimirovna.
She said that at the DAR perinatal center today a specialized department is being formed for pregnant women suffering from diabetes mellitus. The decision was made taking into account regional and global statistics - over the past few years, the number of pregnant women with diabetes has tripled. Such women belong to a high risk group and are accumulated in a third-level institution, as they require special attention by obstetricians-gynecologists, endocrinologists and neonatologists. This is a new direction in obstetrics, which does not yet work in all regions of Russia.
Although average age doctors - 37 years old, relatively young, it includes representatives of higher educational medical institutions and doctors involved in scientific work. A number of specialists have completed advanced training and residency at universities in the capital, in particular, at the department of obstetrics, gynecology and reproductive medicine RUDN University in Moscow. On the basis of the regional perinatal center there is a department of obstetrics and gynecology with a further education course at the Altai State Medical University, where practical lessons students and joint research work.
2980Photo by Evgeniy NALIMOV On March 1, State Duma deputies Daniil Bessarabov and Nikolai Gerasimenko visited the DAR perinatal center to determine its readiness for work. Chief physician Irina Molchanova showed all the structural divisions of the center, which, as promised earlier, are ready for work. So, on the fifth floor there is a fully equipped laboratory. At the time of the deputies’ visit, a chromosomal analysis was being carried out in one of its blocks, which made it possible to identify fetal pathologies in the early stages of pregnancy. The fourth floor will soon become a permanent site for the center for family health and reproduction, better known as the IVF center. Currently, 1,250 children have been born in the Altai Territory with the help of the center’s specialists. Currently, 1,200 IVF procedures are performed in the region per year. This volume allows you to fully satisfy the needs of couples with infertility problems. However, specialists also solve other problems, for example, miscarriage. On the same floor there is an adult intensive care unit, also ready to receive patients. The perinatal center provides for the mother and child to stay together if the baby does not have serious pathologies requiring specialized care. The individual rooms have everything necessary for a convenient and comfortable stay and care for the baby and mother. Even feeding will be organized directly in the wards. This will avoid unnecessary contacts, as well as the spread of nosocomial infections, which are most dangerous for newborns. A convenient large sink-bath with a moving shower will allow you to maintain your newborn’s hygiene without any problems. As the Minister of Health of the Altai Territory Irina Dolgova clarified, the equipment and medical furniture in the wards are of domestic production. All this is of very high quality and has the appropriate certificates. Also in the same department there is a ward intensive care for newborns. In these chambers it is carried out short-term treatment, that is, literally on the first day. Therefore, mothers are not there 24/7, but they can visit the baby. The rest of the time, supervision and care are provided nurse. In total, we have two such wards with three beds and two separate boxes - for a total of 8 people,” they said in the postpartum department. The operating rooms are also almost ready. As Irina Molchanova especially emphasized, the center, including the operating rooms, provides the most non-contact methods. You can even open the door to the operating room without touching it - special sensors work. Today, neonatologists will not touch the child with their hands, only with special tools and devices. It is non-contact medicine that provides the conditions in which babies born, for example, survive ahead of schedule or with any pathology. At the moment, it is known that the biggest carrier of infection is the hands,” she said. - And we follow this principle in everything. During the visit, Nikolay Gerasimenko and Daniil Bessarabov talked with patients and medical staff of the center and appreciated it high organization and an integrated approach to solving any problems. The next day, as part of a special commission, State Duma deputy doctor Valery Elykomov visited the new perinatal center. Nikolay Gerasimenko, doctor, member of the State Duma Committee on Health Protection: I am the head of the federal project “Healthy Future” of the United Russia party. One of its directions is monitoring the implementation of the construction of perinatal centers throughout Russia. Therefore, it was important for me to see with my own eyes what was happening here. Now I can say that I am shocked by the organization of the center’s work. The Altai Perinatal Center is the largest of the 32 that are being built throughout Russia. Its 190 beds and the capabilities of the perinatal center on Popova provide powerful potential for reducing infant and maternal mortality. It is impossible for amateurs to evaluate medical institutions. Specialists from Roszdravnadzor and Rospotrebnadzor work with the center and evaluate everything objectively. I can say for sure that the DAR center deserves the highest rating. By the end of the first half of the year, I believe it should reach its capacity. Daniil Bessarabov, member of the State Duma Committee on Labor, Social Policy and Veterans Affairs: This is a unique facility, including in terms of location, medical equipment, architecture and process logistics. The professionals who work here are trained in leading clinics in the country and have extensive personal experience. But the most important assessment, in my opinion, has already been received from the lips of expectant mothers. During the last regional week, I received more than one call from remote areas of my district. Women want to give birth within the walls of this particular center, and this means a high degree of trust in specialists. Any enterprise needs time to reach its planned capacity so that all processes work normally. The perinatal center, as a new institution, has just begun its work, and we need to help it get on its feet, form a team, organize work around the edge and then move forward with confident steps. Valery Elykomov, doctor, member of the State Duma Committee on Health Protection: Today we spent two and a half hours touring the new perinatal center. Today it is a working structure for those types of licensed activities for which it currently accepts patients. Monitoring of pregnant women, the possibility of transporting them here and the readiness of all services and bases to work in emergency conditions. It is also important that the perinatal center can observe newborns, if necessary, for up to three months. As a former chief physician of several medical institutions I can say that at a glance magic wand it is impossible to launch a large structure. I remember well the opening of the regional clinical hospital- at first there were only 40 beds, then 270, then 870 and today - 1265. But we have never had institutions of this type like the DAR center. Women should know that our region has enough strength, resources and qualifications to save the life of a mother and child if necessary.
Opinions
In the Altai perinatal center "DAR" all planned departments were operational: gynecological, obstetric, postpartum, departments of pathology of pregnancy and pathology of newborns, obstetric hospital. More than 30 babies have already been born here. Patients are also consulted by doctors from the entire mountain cluster, which includes seven medical institutions.
Contact via Skype - hospital in Shelabolikha. Doctors of the DAR perinatal center call the districts every week, study the regional register of pregnant women and invite women from high-risk groups to see them. Yulia Shumkova recently gave birth to a son at the perinatal center. She came to DAR twice during her pregnancy: she has a pathology of the thyroid gland.
As Svetlana Teplukhina, an obstetrician-gynecologist at the perinatal center, explained, “this can be any pathology: pregnant women are observed with us hypertension, With bronchial asthma, with other severe extragenital pathologies. And therefore we carry out hospitalization in the institution that the woman needs at this stage shown."
Maria Vorobyova is expecting twins. She has an artificial heart valve. Gynecologists are constantly in touch with regional clinical cardiologists. And Tatiana asks not to show her face. She has chronic renal failure. Having been diagnosed with pregnancy being contraindicated, the woman took the risk of carrying the baby to term and now goes for hemodialysis every day. In Russia, there are cases of successful births with this diagnosis: in Irkutsk and Orenburg. In Barnaul they took up difficult case, but warned the woman about another possible outcome.
Tatyana, a patient at the perinatal center, shared: in general, they told me that getting pregnant... It’s not that it’s contraindicated, but then it happened, and my husband and I decided to continue the pregnancy. What if everything will be fine? What if everything works out?
As Elena Draganik, director of the Barnaul dialysis center, says, “the management of such patients is very complex, this involves joint meetings with gynecologists. This is a lot of joint work between doctors over the course of 9 months.” For the sake of great work in the name of life, they built the DAR perinatal center. In the world and in the region, the leading position in the structure of maternal mortality is occupied by somatic pathologies - this is when, during pregnancy, women experience worsening chronic diseases. The Altai Territory is now ready to resist this negative trend.
And such a “fine line of management of such patients, it can only be carried out in the community of all doctors who are concentrated on this site: KKB and the perinatal center. - Only in such a complex can we preserve the health of the mother and get healthy child", Irina Molchanova, chief physician of the DAR perinatal center, is sure.
Meanwhile, the Barnaul authorities announced a competition to develop a project for improving the territory of the medical cluster. 3.5 million rubles are allocated for this from the city budget. And the regional government promised to finance the work itself. The exact amounts will be announced after the project is developed. So, next to the Dar perinatal center, the road will be widened, several parking lots will be created and additional traffic lights will be installed. Landscaping should begin in the summer.
Also in the area between the Dar perinatal center and Federal Center Traumatology, it is planned to equip a recreation area with benches and walking paths. In addition, city authorities want to install additional traffic lights on the Zmeinogorsky tract next to the Dynamo ski base. Now it is difficult to travel there, including for ambulances.
