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Friday, 23 June 2017

DOI: 10.21045/2071-5021-2017-55-3-2

Shuvalova M.P., Pismenskaya T.V., Grebennik T.K.
Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Healthcare of the Russian Federation, Moscow, Russia

Contacts: Tatyana V. Pismenskaya, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Shuvalova M.P., http://orcid.org/0000-0002-6361-9383
Pismenskaya T.V., http://orcid.org/0000-0002-4269-7913
Grebennik T.K., http://orcid.org/0000-0001-9619-1574
Acknowledgments.The study had no sponsorship.
Conflct of interests. The authors declare no conflict of interest.


Background. Development of the three-level system of care delivery to women during pregnancy, labor and post-partum period and to newborns is a current state priority and is associated with progress in reducing infant and maternal mortality in Russia.

The study purpose was to determine approaches to assess performance of the third level of the system of perinatal care regionalization in the Russian Federation.

Methods. The authors conducted a retrospective analysis of data of the Federal continuous statistical observation, form #232 Data on regionalization of obstetric and perinatal care in maternity hospitals (departments) and perinatal centers in 2013 and 2016. All available data were analyzed both for national and regional levels.

Results. The study showed that reduction in perinatal mortality, neonatal lethality and number of maternal deaths in the third level facilities during 2013-2016 was accompanied by reduction in the similar national-level indicators.

Almost in every second Russian region regionalization of the perinatal care delivery resulted in positive outcomes, including reduced perinatal mortality and neonatal lethality both in the third-level obstetric hospitals and facilities of the overall three-level system.

Conclusions. Development of the three-level system of care delivery to women during pregnancy, labor and post-partum period and to newborns is still in progress.

The existing regulatory framework is not focused on determining target performance indicators of the third level obstetric hospitals. Parameters characterizing the core trend in distribution of regional indicators can serve as standard values.

Keywords: perinatal care; third level facilities; obstetric service; perinatal center; regionalization of medical care.


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