IMPORTANCE OF THE QUALITY OF DISPENSARY OBSERVATION DURING PREGNANCY FOR REDUCING INFANT MORTALITY

Abstract

In the Chechen Republic, which has high infant mortality rates, the average rate of decline in indicators over the past five years is fixed 13.3%. In order to assess the impact of dispensary observation of pregnant women in antenatal clinics on the level of infant mortality in the republic, the analysis of official statistics data and information obtained by copying from Form No. 32 “Information on medical care for pregnant women, women in labor and postpartum” for 2018–2022 was carried out. It was established that during the study period in antenatal clinics of the Chechen Republic an increase in early coverage of pregnant women with dispensary observation by 15.6%, examinations by a therapist before 12 weeks of pregnancy — by 13.2%, ultrasound procedure made — by 26.0% and biochemical screening — by 21.0% was achieved, which made it possible by 2022 to improve the level of these indicators to exceed the Russian average values. In the Chechen Republic, the frequency of detection of pre-existing hypertension complicating pregnancy and childbirth (5.2 times), diseases of the circulatory system (2.2 times), venous complications (1.6 times), diabetes mellitus (28.9 times), urinary tract infections (3.7 times) and placenta previa, including bleeding (1.7 times) is lower than the average in Russia. At the same time, the region has a higher incidence of preeclampsia (moderate and severe) and anemia (2.4 times), eclampsia during pregnancy (1.3 times) and premature placental abruption (1.4 times). In the republic, with an improvement in the detection of hypertension by 2.5 times (from 3.60 to 9.00‰), preeclampsia by 1.8 times (from 55.02 to 101.42‰) and anemia by 1.8 times (from 365.42 to 649.81‰) the frequency of eclampsia decreased by 1.4 times (from 0.24 to 0.17‰) and venous complications by 2.3 times (from 33.30‰ to 14.80‰). In addition, over five years in the region, the incidence of placenta previa has increased 1.8 times (from 2.59 to 4.56‰), cases of diabetes mellitus has increased 3.0 times (from 2.59 to 4.56‰) and 2.5 times — cases of urinary tract infections (from 6.20 to 15.30‰). In the Chechen Republic, where there is a lower proportion of children born with a body weight of up to 2500 grams (1.5 times) and a high proportion of normal births (1.4 times), 1.7 times less likely to detect congenital malformations in the fetus and 3.9 times less in women with pregnancy abnormalities. Thus, improvement of the quality of clinical observation of pregnant women in antenatal clinics of the Chechen Republic had a significant impact on reducing the infant mortality rate in the region.