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UT-Expert:obstetrics and gynecology departments improve quality of care

In recent years, maternal and infant mortality in the country decreased more than three times. But what next? What are the doctors focusing on today? 

Uzbekistan Today correspondent interviewed the main obstetrician-gynecologist of the Ministry of Health, Director of JSC "Republican Specialized Scientific and Practical Medical Center of Obstetrics and Gynecology", Professor Dilbar Nazhmutdinova.

-Our challenge is to further improve the quality of care. This in turn will lead to further reduction of maternal and infant mortality. There is a lot of work to be done. We are developing and implementing new higher standards in the field of obstetrics and gynecology, in accordance with the recommendations of the World Health Organization. Doctors of Science, leading experts of national centers, and doctors working in regional hospitals are taking part in the development of new standards. At the same time, we hold meetings to discuss all the controversial issues.

The new standards clearly itemize responsibilities of all specialists: general practitioners in rural medical centers and family clinics, as well as the doctors working in the republic centers. Strict guidenlines are provided defining the boudaries of each specialist. Physicians are instructed, in which cases to assist the patient and when to forward the patient to another specialist.

The new standards are not just a formality, they are instructions for everyday use.

We are focusing on the development and implementation of screening programs, which will help us identify diseases at early stages. For example, the screening for cervical cancer - a disease that is life-threatening, but treatable in the early stages. This year's program should start working across the country and it should include all women of childbearing age, which is about 8 million people.

We continue to introduce new high-tech methods to the regional hospitals. Our Republican Specialized Scientific and Practical Medical Center of Obstetrics and Gynecology Republican Perinatal Center have something to share with colleagues from the regions. In particular, we are actively engaged in the introduction of minimally invasive endovisual technologies this year. Previously all gynecological operations were carried out via a large incision of soft tissues of the abdomen, from now on the majority of surgeries should be executed with the help of special equipment through soft tissue punctures.In medical language, such surgeries are called laparoscopy.

Special training centers, equipped with dummies are set up on the basis of our and perinatal centers. We will prepare specialists in collaboration withTashkent Medical Institute. The Ministry of Health promises to equip all regional perinatal centers with the necessary high-tech equipment, before the end of the year.

In the preparation of regional experts, we will focus on the introduction of organ operations. For example, our method balloon tamponade in 97% of cases of intractable therapeutic treatment helps avoid the removal of uterine stop the bleeding!

In the Republican centers, we will introduce a new technology to assist with the Rh blood conflict between the woman and the fetus. The new technology allows to "replace" the blood of infants, and thus save his life in the womb.

If we talk about the future, in obstetrics and gynecology, as well as in other areas of medicine a brand should appear. The Republican Specialized Scientific and Practical Medical Center of Obstetrics and Gynecology should be that brand. Last year, with the transformation of the center into a corporation, we received all the necessary management tools. This is a long-term project and our center will become a unique clinic in the process. Every woman, regardless of the problems she faces, must receive the necessary assistance with the help of the most modern technology at our center.

There is no need of passing along the patient from one clinic to another, when everything can be done in one place. We can’t do everything yet, but we are aiming to able to tackle any health problem in the near future, when we have all the neccesary equipment. For example, uterine fibroids can be treated at Tashkent Medical Academy. Using angiographic device they block blood supply to the tumor, and it ceases to grow, shrinks. Our center needs to acquire angiograph in order to be able to treat patients using that procedure.

On the way to achieve these goals, we will have to solve problems of varying complexity. And not everything will depend on our doctors. I had a patient yesterday with the question at the reception: "Why can’t you do vitro fertilization in Uzbekistan, and people are forced to seek assistance abroad.”

Today we have plans for opening of a branch for vitro fertilization. We will start working on that this year, after modernizing the surgical equipment. When we will create a department of IVF, we will have to deal with a lot of regualtions and laws.










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