P.L.SHUPYK NATIONAL MEDICAL ACADEMY OF POST-GRADUATE EDUCATION, KYIV, UKRAINE.
STATE INSTITUTION INSTITUTE OF PEDIATRICS, OBSTETRICS AND GYNECOLOGY NAMED ACADEMIC ELENA M.LUKIANOVA, NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE.
Wiad Lek. 2021;74(3 cz 2):761-766.
The aim: To realize analysis and assessment of completeness and efficacy in the field of perinatal aid regionalization in Ukraine.
Materials and methods: A retrospective analysis has been carried out as well as assessment of inculcation steps concerning regionalization of perinatal health care in Ukraine according to the data of state and branch statistics and monitoring (in 2013-2017). The methods used here are systemic approach, bibliography method, and statistical data evaluation.
Conclusions: It is shown the modern globally acknowledged three-level system of perinatal health care has been organized and functions in Ukraine, perinatal tertiary level centers are now act in the majority of regions. The perinatal health care realization during these last years is shown to be able to assure the providing of adequate perinatal aid taking into consideration the calculated data concerning the pregnant women concentration with high perinatal risks in third level institutions; these patients include pregnant women with heart defects (63.2-69.9%), circulatory system defects (48.5-50.5%), diabetes mellitus (46.7-53.3%); in institutions of the second-third levels, there are 74.2-83.0% of patients with severe gestoses. According to functional possibilities of perinatal aid institutions of different levels, they assure 62%-64.5% of births with body mass 500-999 g and 53.9%-55.3% of ones with body mass 1000-1499 g in perinatal clinics of the third level; it guarantees the survival of newborn babies with body mass 500-999 g and 1000-1499 g during their first 168 h reaching 60.1-65.1% and 89.4%-90.4%, respectively. Efficacy of perinatal aid regionalization is confirmed by a positive tendency of perinatal mortality index; it has become significantly lower: in 2010, the perinatal mortality reached 10.54 cases per 1,000 of newborn alive and dead babies, this index having dropped to 8.89 in 2019. The maternal mortality levels have also decreased from 23.5 up to 14.9 cases per 100,000 of babies born alive. Perinatal aid regionalization in Ukraine is being realized according to international strategies permitting to provide effective perinatal aid to patients at each level of its provision depending on patient's need.
分析和评估乌克兰围产期援助区域化的完整性和效果。
回顾性分析乌克兰根据国家和分支机构统计数据和监测数据（2013-2017 年）实施围产期保健区域化的纳入步骤。所用方法包括系统方法、文献方法和统计数据评估。
乌克兰已组织并运作了现代全球公认的三级围产期保健系统，大多数地区都有围产期保健三级中心。近年来，围产期保健的实施能够确保在考虑到高围产期风险的孕妇在三级机构中的集中程度的计算数据的情况下提供适当的围产期保健；这些患者包括患有心脏缺陷的孕妇（63.2-69.9%）、循环系统缺陷（48.5-50.5%）、糖尿病（46.7-53.3%）；在第二至三级机构中，有 74.2-83.0%的患者患有严重的妊娠中毒症。根据不同级别围产期保健机构的功能可能性，它们确保在三级围产期诊所中 62%-64.5%的体重 500-999 克的婴儿和 53.9%-55.3%的体重 1000-1499 克的婴儿出生，在围产期诊所中保证体重 500-999 克和 1000-1499 克的新生儿在前 168 小时的存活率分别达到 60.1-65.1%和 89.4%-90.4%。围产期援助区域化的效果得到了围产期死亡率指数积极趋势的证实；它显著降低：2010 年，每 1000 名活产和死产婴儿的围产期死亡率达到 10.54 例，这一指数在 2019 年降至 8.89 例。产妇死亡率也从 23.5 例降至每 10 万活产婴儿 14.9 例。乌克兰围产期保健区域化是根据国际战略实施的，根据患者的需求，允许在提供的每个级别为患者提供有效的围产期保健。
