Obstetrics and Gynecology - A.M. Hromova 2000

Structure and Organization of Obstetric and Gynecological Care in Ukraine
Women's Health Clinic

The antenatal clinic is an outpatient, dispensary-type department whose work best reflects the core principle of modern healthcare: the integration of Prevention and Treatment.

The mission of the antenatal clinic is to provide medical and preventive care aimed at improving women's health and reducing maternal and perinatal morbidity and mortality.

To achieve this goal, the antenatal clinic addresses the following objectives:

1. Structure/175.html">Implementation of medical and preventive measures aimed at preventing complications during Pregnancy, childbirth, the postnatal period, and gynecological diseases, as well as providing perinatal fetal protection.

2. Provision of qualified obstetrical and gynecological care.

3. Carrying out work on Contraception and abortion prevention.

4. Introduction of Modern Methods of Diagnosis, prevention, and treatment of pregnancy pathology, disorders in postpartum women, and gynecological patients into clinical practice.

5. Conducting health education and promotion activities.

6. Ensuring social and legal protection for women in accordance with legislation on maternal and child health.

7. Ensuring continuity in the examination and treatment of pregnant women, postpartum women, and gynecological patients.

8. Maintaining systematic communication with maternity hospitals (departments), polyclinics, emergency and urgent care departments, and other healthcare facilities (tuberculosis, dermatovenereological, and oncological dispensaries, etc.).

9. Conducting family planning activities.

Antenatal clinics operate in conjunction with obstetric inpatient facilities and polyclinics, or as independent medical and preventive institutions.

Despite the multitude of tasks performed by physicians during prenatal care, the primary objective remains the identification of women at high risk for perinatal and maternal mortality. Such patients require targeted preventive measures and delivery in a specialized hospital facility appropriate to the identified risk level.

Grade I (low risk) includes second- or third-time mothers with an uncomplicated pregnancy; primigravidae without obstetric complications or extragenital diseases and with normal obstetric anthropometric data; and primiparae with no more than one uncomplicated abortion in their medical history.

Grade II (moderate risk) includes pregnant women with extragenital diseases, an anatomically narrow pelvis, fetal macrosomia, abnormal fetal presentation, Placenta Previa, as well as older pregnant women (over 30 years of age). This group also includes women with gestosis, infectious complications, fetal demise, a history of multiple abortions or perinatal fetal loss, recurrent Miscarriage or threatened miscarriage, deliveries complicated by Hemorrhage, and women with a history of uterine surgery.

Grade III (high risk) includes pregnant women with severe extragenital conditions, such as rheumatic or septic endocarditis, Heart Failure, stage II–III Hypertension, exacerbation of systemic Connective Tissue diseases, hepatosis, placental abruption and placenta previa, bacterial and pain Shock, and Amniotic Fluid Embolism.

Referring pregnant women to inpatient facilities based on their risk level ensures a phased approach to childbirth and helps reduce perinatal and maternal mortality.