OPTIMIZATION OF A REGIONAL MODEL OF PERINATAL MONITORING AND MANAGEMENT TACTICS FOR CHILDREN WITH CONGENITAL OBSTRUCTIVE UROPATHY
Keywords:
obstructive uropathy, prenatal diagnosis, newborns, hydronephrosis, perinatal monitoring, cost-effectivenessAbstract
This article presents an improved three-tier model for perinatal monitoring of congenital obstructive uropathies (COU), adapted for the Samarkand region. The author proposes a transition to a "fetus as patient" paradigm, including the use of a "Prognostic Screening Sheet" at primary care level and the implementation of the "72-Hour Rule" for postnatal ultrasound diagnostics. Implementation of the model has reduced the average age for surgical correction of COU from 8.5±2.1 to 3.2±1.4 months. Early decompression of the urinary tract in the first three days of life for critical defects has been shown to reduce the nephrectomy rate by 18%. Optimization of patient management tactics has yielded significant economic benefits by streamlining hospital bed use and eliminating unnecessary invasive examinations. The proposed algorithm helps prevent early disability in children with urinary tract pathologies.
References
Babatova SI, Sugak AB, Filippova EA, et al. The role of the timing of the first ultrasound examination in assessing the expansion of the pelvicalyceal system in newborns. Praktika pediatra. 2024; 3: 11-17. (in Russ).
Ignatova MS, Morozov SL, Kryganova TA. Modern approaches to antenatal ultrasound diagnosis of fetal urinary system malformations. Klinicheskaya nefrologiya. 2013; 2: 58-64. (in Russ).
Makovetskaya GA, Terekhin SS, Danilova ZB, Bazranova YY, Barinov IV. Interdisciplinary approach to the management of children with obstructive uropathies as a basis for preventing the progression of chronic kidney disease. Klinicheskaya nefrologiya. 2011; 4: 55-59. (in Russ).
Sergeeva SV. Diagnosis and treatment of newborns and infants with severe hydronephrosis (literature review). Rossiyskiy vestnik detskoy khirurgii, anesteziologii i reanimatologii. 2020; 10(3): 339-352. (in Russ).
Yatsyk SP, Akhmedov YM, Akhmedov IY. Antenatal diagnosis and the use of fetal surgery methods for obstructive uropathies. Rossiyskiy vestnik perinatologii i pediatrii. 2025; 70(6): 11-20. (in Russ).
Bikbov B, Perico N, Remuzzi G. Congenital anomalies of the kidney and urinary tract (CAKUT) in children: epidemiology, diagnosis and outcomes. Pediatric Nephrology. 2018; 33: 135-148.
Garcia-Rojo E, Cordido A, Garcia-Cenador MB, et al. International Consensus on Antenatal Hydronephrosis: Definitions, Classification, and Follow-up. Pediatric Nephrology. 2022; 37(12): 2859-2871.
Peters CA, Bongers EM, Avner ED. Congenital anomalies of the kidney and urinary tract (CAKUT): from antenatal diagnosis to postnatal management. Journal of Pediatric Urology. 2017; 13: 313-321.
Rizayev Jasur , Yuldosheva Shakhnoza , Mamasolieva Shoxista . Forming and
improving a healthy lifestyle among students of higher educational institutions / Journal of Biomedicine and Practice. 2022, vol . 7, issue 3, pp . ]
Rizaev Zh. A., Ruzimurotova Yu. Sh., Turaeva S. T. INFLUENCE OF SOCIAL AND HYGIENIC FACTORS OF WORK AND LIFE ON THE HEALTH OF NURSES // Scientific progress . – 2022. – T. 3. – No. 1. – S. 922-926.
Утепов П. Д., Ризаев Ж. А., Тухтаров Б. Э. БИОЛОГИЧЕСКАЯ БЕЗОПАСНОСТЬ В МЕДИЦИНСКИХ УЧРЕЖДЕНИЯХ //Stomatologiya. – 2024. – Т. 94. – №. 1. – С. 62-72.
Rizaev Jasur , Nodirjon Khaidarov , Abdullaev Sharif. Current views on the diagnosis and treatment of glossalgia . Journal of Biomedicine and Practice. 2021, vol. 6, issue 6, pp. 160-164
