THE MODERN ORGANIZATION OF MEDICAL CARE BY THE NEWBORN WITH CRITICAL CONGENITAL HEART DISEASES AT THE PRESURGICAL STAGE

Abstract

Purpose. Studying of efficiency of new organizational approaches to providing the medical care (MC) to newborns with critical congenital heart diseases (СHD) in for 2007–2012.

Materials and methods. The analysis of providing MС by the newborn with СHD during 2007–2010 (119 children) and 2011–2012 (113 children) was carried out. Clinical and anamnestic data, indicators of an echocardiography prenatal and post-natal, an electrocardiography, laboratory researches, intensive conservative therapy, and hospitalization outcomes were studied.

Results. With the organization of regional perinatal center (RPC) organization the providing MC newborn with CHD was based by the principles: a) the second stage of prenatal ultrasonic screening was guided by RPC; b) dynamic supervision of pregnant women with suspicion of CHD of fetus at a stage of prenatal hospitalization in RPC; c) joint approach in definition of tactics of maintaining the newborn patient with CHD (the organization of an interdisciplinary neonatal cardiological consultation); d) widespread introduction and availability of hi-tech methods of diagnostics and treatment, including surgeries on early terms in the Kuzbass cardiocenter. Productivity of prenatal diagnostics increased. During 2007–2010 39,5 % of hospitalizations ended with transfer to expeditious treatment. In 2011–2012 already 61,9 % of children are transferred to cardiac hospitals (р=0,001). The lethality in the first group made 21,0 %, in the second – 7,1 % (р=0,002).

Conclusion. Introduction of new organizational approaches in providing MC newborn with CHD allowed to improve diagnostics of critical conditions, to provide timeliness of cardiac correction and to lower a lethality at a presurgical stage.