Obstetric care organization in the multidisciplinary hospital structure

A.S. Shkoda¹, A.D. Podtetenev¹, I.V. Bakhareva², A.B. Dobrova¹, K.A. Pokrovskii¹, S.G. Vediashkina¹, M.A. Loskutnikov<sup>1

1</sup>City Clinical Hospital No. 67, Moscow
²Pirogov Russian National Research Medical University, Moscow

The article presents new opportunities for obstetric and gynecological service in a large multidisciplinary hospital — City Clinical Hospital No. 67. Quality improvement of the health care delivery became possible due to Moscow healthcare system modernization, handled between 2014 and 2017. Structural reforms have made it possible to increase the economic efficiency of the medical facility, to optimize the logistical patient flows of the obstetric and gynecological area, and to make health care delivery more accessible and patient-oriented. A clinical case of a patient, hospitalized in 28–29 weeks of pregnancy in critical condition, is presented in this article. Within CT angiography, she was diagnosed with acute intraventricular hemorrhage in consequence of the arteriovenous malformation (AVM) rupture of the vertebrobasilar basin. Conservative treatment was conducted after operative delivery (cesarean section) in the Department of Neurological Resuscitation of the City Clinical Hospital No. 67 with the subsequent radiosurgical treatment of AVM in the N.V. Sklifosovsky Scientific Research Institute of First Aid. The parturient was discharged in a satisfactory condition. Comprehensive health care delivery for patients with the severe condition is carried out in close collaboration of all the clinical centers of the City Clinical Hospital No. 67 with the use of new medical technologies and multidisciplinary approach, as well as the hospital work coordination with other Moscow medical facilities.

Keywords: obstetric and gynecological service, medical emergencies, intraventricular hemorrhage, ACVA, arteriovenous malformation, pregnancy, CT angiography, new medical technologies, patient-orientation.
For citation: Shkoda A.S., Podtetenev A.D., Bakhareva I.V. et al. Obstetric care organization in the multidisciplinary hospital structure. RMJ. 2019;1(I):33–36.