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Main arrow Archive of previous Issues arrow ╣3 2011 (19) arrow Novel organization schemes in maternity care: population-based pre-gestation training
Novel organization schemes in maternity care: population-based pre-gestation training Print
Friday, 30 September 2011

Summary. This study summarized 2001-9 periodĺs certain experiences of Samara Region in primary-stage-prevention of pre-natal pathologic developments in the fetus. Some organizational and technological constituents of operation of units for disease prevention in municipal medical establishments in this Region were selected for the analysis of the situation with pre-gestation training. Evaluation of efficiency of operation of such units was performed along a unique measure, that was the rate of healthy born offspring. Two groups were created: the group of parturient women who had received pre-gestational training and the control group of non-receivers.

Parameter and none-parameter statistical techniques were implemented for statistical analysis.

Pre-gestational training for future expectant mothers/parturient women including peri-conception disease-development-prevention measures has been introduced in healthcare services as quite a novel facility derived from units for disease prevention within gynecological clinic. This innovation has become true with arranging coordination of physicians of different specialties within the general algorithm of consultation service. Logistics for patients supply, as well standardized protocol of pre-gestation training of future expectant mothers/parturient women were also necessary elaborations.

All-embracing verification of operation of establishments of primary medical sanitary care, listening to projects-in-question at medical boards of medical establishments, as well as at governing boards for public health (from Municipal to Regional level), adoption of relevant resolutions implying dynamic control for them were all necessary for the creation and continuous improvement of these new medical services (i.e. consultation and pre-gestational training of future expectant mothers/parturient women).

This study demonstrated that pre-gestational training decreased the risks of developing in-born malformation and other deviations in health condition of future newborns.

Decreased rate of newborns with folate-dependent inborn malformations, with nerve tube defects, an-encephalia, encephalocele, spinal cord hernias, as well as with prominent iodine deficiency was noted in birth outcomes with parturient women who had received pre-gestation training. 62.7% of parturient women producing healthy offspring had received pre-gestation training, while among those producing diseased offspring it was only 12.3% (χ2=12.4; ­=0.026).

Cost-efficiency estimates demonstrated that pre-gestation training saved 7,000 rubles per each pregnant woman.

Key words. Pre-gestation training, units for disease-prevention, inborn malformations, morbidity in newborns.


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