Medical Science | Open Access | DOI: https://doi.org/10.37547/tajmspr/Volume08Issue04-18

Improving the Perinatal Monitoring System and Optimizing Therapeutic and Diagnostic Tactics at The Regional Level

Akhmedov I.Yu. , Samarkand State Medical University, Uzbekistan
Rizaev Zh.A. , Samarkand State Medical University, Uzbekistan
Yatsyk S.P. , Samarkand State Medical University, Uzbekistan
Akhmedov Yu.M. , Samarkand State Medical University, Uzbekistan

Abstract

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.

Keywords

Melatonin, acute cerebral circulatory accident, ischemic stroke

References

Morozov DA, et al. Pediatric surgery and the system of perinatal care. Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2015;5(2):12-18.

Babatova SI, et al. Features of renal function in the early neonatal period. Medical Journal of Uzbekistan. 2022;4:45-50.

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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Akhmedov I.Yu., Rizaev Zh.A., Yatsyk S.P., & Akhmedov Yu.M. (2026). Improving the Perinatal Monitoring System and Optimizing Therapeutic and Diagnostic Tactics at The Regional Level. The American Journal of Medical Sciences and Pharmaceutical Research, 8(04), 124–129. https://doi.org/10.37547/tajmspr/Volume08Issue04-18