Improving the Perinatal Monitoring System and Optimizing Therapeutic and Diagnostic Tactics at The Regional Level
Keywords:
Melatonin, acute cerebral circulatory accident, ischemic strokeAbstract
Background: ongenital obstructive uropathies (OU) significantly contribute to neonatal morbidity. This study aims to evaluate an improved three-tier regional model of perinatal monitoring adapted for the Samarkand region.
Methods: A prospective study was conducted (2020–2026) involving the development of a "Prognostic Screening Sheet" based on maternal risk factors (OR analysis) and a standardized "72-hour rule" for postnatal ultrasound.
Results: The implementation of the model reduced the average age of surgical correction from 8.5 \pm 2.1 to 3.2 \pm 1.4 months. Early decompression in critical cases (e.g., posterior urethral valves) was shifted from day 25 to day 3 of life. Nephrectomy rates decreased by 18% , and hospitalizations for acute pyelonephritis in the first year dropped by 32%.
Conclusions: The transition to a "fetus as a patient" paradigm and the integration of obstetric and pediatric services ensure organ-preserving outcomes and prevent early-stage chronic kidney disease.
References
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National Clinical Guidelines. Congenital obstructive uropathies in children: diagnosis and treatment. Ministry of Health of the Republic of Uzbekistan; 2024.
Assessing Fetal Urodynamics. In: Textbook of Perinatal Medicine. 3rd ed. New York, NY: Springer; 2021:1120-1135.
Shcherbakov AV. Diagnostic errors in neonatal urology. Russian Bulletin of Pediatric Surgery, Anesthesiology and Reanimatology. 2019;9(3):22-29.
Samarkand State Medical University. Regional model of perinatal monitoring for congenital malformations. Scientific and Practical Conference Proceedings. 2025:88-91.
Yatsyk SP, Akhmedov YuM, Akhmedov IYu. Antenatal diagnosis and the use of fetal surgery methods for obstructive uropathies. Russian Bulletin of Perinatology and Pediatrics. 2025.
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Copyright (c) 2026 Akhmedov I.Yu., Rizaev Zh.A., Yatsyk S.P., Akhmedov Yu.M.
This work is licensed under a Creative Commons Attribution 4.0 International License.
