MOSCOW, July 3. / TASS /. / TASS /. Fifty-five children out of sixty-four, born with an extremely low body weight of up to 1 kg, were rescued by doctors in the Kaliningrad region in 2017. The statistics of rescued newborns with such a low weight is considered in a special way - after a calendar year, because the child can be in the hospital for many months, the Minister of Health of the Kaliningrad Region Alexander Kravchenko told TASS.
"The rescue of children with extremely low body weight can last for eight or nine months, so we count in a calendar year. The latest official statistics are for 2017. There were 64 children with extremely low body weight of up to one kilogram, and we lost nine children," said Kravchenko.
Survives less than half
According to the professor, deputy director of the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of Russia Dmitry Degtyarev, in total in Russia in 2018 1829 children were born with a body weight of 500 to 750 grams. The majority were concentrated in perinatal centers, of which 36% died, excluding newborns transferred to children's hospitals.
"In fact, a child born at 23 weeks is a fetus that is in the middle of the path to full maturity. It would have to receive all the necessary nutrients from the mother's body for another four months, carry out gas exchange through the placenta, bypassing undeveloped lungs," says the professor.
According to him, in order to save such children, technologies of such complexity are needed, which are used only in the space industry. "To leave such a child, you need to have not just equipment for newborns, but specifically specially created for children with extremely low body weight. We can say that this is the most high-precision equipment that can be in medicine. Equipment of modern regional perinatal centers, including in the Kaliningrad region, as well as the knowledge and skills of medical personnel increase the chances of survival for this category of children.But you need to understand that the probability that a child weighing less than 750 grams will live to the age of one year, not only in most regions of our country, but also in most developed countries of the world - below 50%, "- said the professor.
Professionals are worth their weight in gold
Degtyarev notes that modern technologies alone are not enough for caring for premature babies. It is important to have enough trained specialists on the staff. According to him, the state has been making efforts in recent years to ensure that the number of specialists corresponds to the capabilities of new technology and the number of perinatal centers. However, in many regions they are lacking.
“Somewhere there may be a shortage of 20% of neonatologists, and there are regions where the shortage of specialists in intensive care for newborns reaches 50%. The situation with the provision of neonatal nurses is even worse. anesthesiologist-resuscitator at the same time.To fully train a person in both specialties, in total, it takes at least three years (ideally - four to five).Unfortunately, the beginning doctor has neither the time nor the money for this. (two years) in one specialty and primary training (six months) in another. Despite the use of simulation training medical centers in personnel training, in most regions perinatal centers were built faster than it was possible to qualitatively train the required number of people, "the professor added.
Degtyarev noted that bringing doctors to criminal responsibility can cause serious damage to the entire professional community: it will scare specialists away from an important profession."People will try to avoid the highest degree of responsibility for the life of a child with an insufficient degree of legal and social protection," he fears.
High level of assistance
According to the regional minister Kravchenko, Kaliningrad is just lucky - there is no significant shortage of neonatologists in the local perinatal center. The equipment of the perinatal center also meets all the necessary standards: there are several large departments for nursing children with 65 beds, a neonatological hospital, a department for newborns with 95 beds.
"For a child who was born prematurely and deeply prematurely, we in the center can provide everything by analogy with the womb. If a child is born at a very young age, then he can be in the hospital and take care of it for a year. He gains weight, develops the respiratory system. In fact, he matures and receives everything that he could not get in the womb, "the minister said.
There is also a visiting neonatological service in the city: as soon as a difficult childbirth begins, the team leaves for the maternity hospital and the child is taken to the perinatal center immediately after childbirth. "There are isolated cases when a child is in such a serious condition that it is simply not transportable. In general, the system of assistance is well and well formed, it is developing," said Kravchenko.
The case in Kaliningrad
On June 30, the investigation filed charges of organizing the murder of the child and. about. the chief physician of the Kaliningrad maternity hospital 4 Elena Belaya and in the commission of premeditated murder to the resuscitator-anesthesiologist of the regional perinatal center Elina Sushkevich. Investigators believe that in November 2018, when a premature baby was born in the hospital, Belaya instructed Sushkevich to kill him by injecting the baby with magnesium sulfate. According to the UK, this was done to save hospital resources and preserve medical statistics.
The Russian Society of Neonatologists came out in defense of the doctors, according to them, the child was born with an extremely low body weight of 700 grams at a gestational age of 23 weeks and 3 days, and throughout the world the probability of survival of such patients without severe complications does not exceed 5-10%.