Problems and achievements of Moscow specialists in the field of neonatal surgery
At present, there is an increase in the birth rate of children with surgical pathology who need surgical treatment sometimes even during the period of newborns. Over the past decade, there have been significant changes in the organization of care for children of the first days of life with surgical pathology at different levels of the health system, which allowed expanding the list of corrected congenital pathologies and reducing child mortality.
Doctor of Medical Sciences, Professor, Chief Children’s Surgeon of the Department of Public Health of the City of Moscow, Head of the Department of Thoracic Surgery and Surgical Gastroenterology of the Children’s Clinical Hospital № 13 named after the doctor of medical sciences, spoke about the problems and achievements in the provision of surgical care for children of the newborn period in the capital. NF Filatov Alexander Yurievich Razumovsky.
– Alexander Yuryevich, please tell us what successes and difficulties are present in your hard work.
The formation of neonatal surgery
– Surgery of the neonatal period is a complex area of modern pediatric surgery. In our country neonatal surgery has been developing for several years and I would like to note that Russian specialists, in particular the capital surgeons, have made a significant contribution to the development of this area of surgery.
In the middle of the last century, outstanding Moscow surgeons S.D. Ternovsky, Yu.F. Isakov, S.Ya. Doletsky and others laid the foundations for the development of neonatal surgery as a separate multidisciplinary area. At the initiative of these doctors, a specialization in neonatal surgery appeared in the training of children’s resuscitators and surgeons. At the same time, the first branches were opened in the capital to provide medical care to children of neonatal age. As a result, the survival rates of this category of patients improved significantly.
- What are, in your opinion, the advantages of prenatal diagnosis?
- As I mentioned earlier, the development of modern diagnostic methods gives us the opportunity to learn about the presence of congenital pathology even at the stage of intrauterine development. Emergency Surgery is relevant in about a third of the cases of the birth of such children immediately after birth and about half of those born with congenital malformations of children need a dynamic observation and rectification of the defect in a planned manner.
In the capital, there are now 3 centers of antenatal care: department on the basis DKB number 13 named. N.F. Filatova, the Center for Family Planning and Reproduction (TsPSiR), and the department on the basis of State Clinical Hospital No. 8. So, for example, in the consultative center of the hospital. N.F. Filatova prenatal examination is more than 400 pregnant women per year. In some cases, in the process of counseling, it is possible to remove the diagnosis, in some cases fundamentally change.
In special cases, doctors of counseling centers explain to future parents about the nature of congenital anomalies, the possibility of conducting corrective operations, their scope. In some cases, medications are indicated for the termination of pregnancy. Some pregnant women need a dynamic observation of fetal development, with the definition of further tactics of labor and the timing of the transfer of a newborn to a specialized department.
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