Yu.G. Sychenkov¹, L.P. Sukhanova^2
1Hospital ¹8, Kaluga region, town of Obninsk
²Federal Research Institute for Health Organization and Informatics of Ministry of Health and Social Development of the Russian Federation, Moscow

Summary. High rates of morbidity and disability of children population of Russia necessitate drastic measures to be taken for safe birth of every child in every obstetrics inpatient facility. Current policies for the modernization of maternity care, based on ideas of high-tech medical service for parturient women and for the childs being born (with certain focus on premature newborns with diminished body weight), propel the creation of nets of perinatal centers and instigate elevation of the grade of provided medical care within the framework of 1st grade inpatient facilities. 2nd and 3rd grade facilities of such kind producing less than 1,500 births a year are incapable of allocating a separate neonatal resuscitation service just because the standardized staff list and funding ressources do not suit for the creation of a separate department of newborns resuscitation, moreover, a 24-hour neonatal physician is also could not be possibly afforded in most of these facilities. The problem is that 1st and 2nd grade obstetrics inpatient facilities generally prevail in Russia, thus making organizational measures for newborns resuscitation in them quite a topical theme.

One obstetrics inpatient facility in the town of Obninsk producing less than 1,500 births a year was enrolled for this study. It was made clear that this facility was not belonging to 3rd grade facilities of this kind, so there did not exist a separate neonatal resuscitation service, but it factually was incorporated in the framework of a joint anesthesiology and resuscitation service of the maternity hospital as a whole. This joint service was entitled as a "department of anesthesiology and resuscitation of the obstetrics and gynecology service with attached units of resuscitation and intensive care for the newborns". The physicians of this department were to provide anesthesiology and resuscitation care for the whole pool of patients of this maternity hospital which included pregnant ladies, parturient women, and puerperal, as well as the newborns delivered here, if such care turned out to be necessary. Nevertheless, clinical outcomes were quite satisfactory for the newborns in the studied period of 2006-2010.

This individual obstetrics inpatient facility was ranked as 2nd grade facility of this kind along the criteria of bed fund volume, staff list volume, total amount of medical care being provided, financial capabilities insufficient for the creation of a separate newborns resuscitation service. This organizational model of resuscitation care for the newborns was considered feasible in this study form the point of view of quite satisfactory clinical results.

Keywords: Newborns' resuscitation; anesthesiology and resuscitation physician; obstetrics inpatient facility; perinatal center; modernization of healthcare.

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