IMPROVING NURSING PRACTICES IN THE CARE OF PREGNANT WOMEN

Аннотация

Maternal mortality is an integral indicator of reproductive-age women’s health, reflecting the impact of economic, socio-hygienic, and medical-organizational factors at the population level. It also serves as a measure of the effectiveness of maternal and child healthcare services. This article discusses the work of midwives and junior nurses within medical teams serving pregnant women, as well as the opportunities available for nurses today. Additionally, the article provides insights into screening examinations designed to further improve women’s health. Information is also provided on comorbidities in pregnant women and the “Healthy Family Room”initiativeestablished in local communities. Key words: maternal mortality, medical team midwife, screening, visiting nurse, pregnant woman, healthy family room, pregnancy-related diseases, amniotic fluid, women’s consultationcenter, diabetes mellitus,UNICEF, maternal and child health protection. Maternal mortality is a fundamental indicator of reproductive-age women's health and reflects the population-wide effects of economic, socio-hygienic, and medical-organizational factors. It also serves as a key measure ofmaternal and child healthcare serviceeffectiveness. (1) Access to emergency medical care is critical for many women, as obstetric hemorrhage is one of the leading causes of maternal death, particularly in cases of hemostatic disorders. (2,3) The most common cause of pregnancy-related bleeding is premature placental abruption (11-45%), along with postpartum and early postnatal hemorrhages (24.2%). Disseminated intravascular coagulation was observed in 10% of cases, with the risk of significant bleeding being linked to specific clinical conditions. Proper organization of prenatal monitoring for high-risk pregnant women, timely hospitalization, adherence to treatment protocols, and the availability of emergency surgical care are crucial in preventing complications. To ensure this, visiting midwives and nurses must register pregnant women promptly and ensure that they undergo all necessary prenatal examinations. Prioritizing women's health is essential. As part of primary healthcare services, women aged 35-55 undergo screening programs, including cervical cancer screening every three years by family doctors. (4)For women aged 45-65, breast cancer screening is conducted 98,7:ROTCAFTCAPMI.SECNEICS LACIDEM,5202, yraurbeF,5emuloV gro.srehsilbupcimedaca.www every two years, including specialist consultations and mammographic examinations. Women aged 15-49 undergo annual preventive check-ups, including assessments for pregnancy contraindications. Specialist consultations and general blood tests are also included in thescreening programs. Within the patronage system, pregnant women undergo medical examinations by a medical team midwife at 12 and 32 weeks of pregnancy. Postpartum women are examined three times—within three days of discharge, and again at 15 and 30 days postpartum. (4) Breast and cervical cancer, which are the leading cause of death among women and occur mainly in 35-65-year-old women, are being screened for early detection.(5)Patronage midwives play a crucial role in monitoring both maternal and infant health from the onset of pregnancy, ensuring all necessary medical check-ups, and overseeing postpartum recovery for 42 days before handing over care to a visiting nurse. Additionally, they educate communities about healthy pregnancies and childbirth. (6) The government prioritizes increasing healthcare accessibility, including the establishment of “Healthy Family” rooms in local communities. These initiatives focus on reducing maternal and child mortality and preventing hereditary diseases among children. (7) Health Risks During Pregnancy Pregnancy increases susceptibility to various diseases, especially infections. Infections affecting the uterus can lead to miscarriage or infertility, highlighting the importance of timely medical treatment. Early intervention prevents premature rupture of amniotic fluid and subsequent septic complications. (8) Normally, amniotic fluid is released after 37 weeks of pregnancy, signaling labor within 24 hours. However, pregnancy-related conditions affecting the placenta can lead to premature rupture. (8) To improve reproductive health and medical care for pregnant women, specialized women’s consultation centers and adolescent health departments have been established. Systematic patronage services and reproductive health initiatives have proven effective. Advances in gynecological diagnostics, treatment, and rehabilitation now align with international standards. Qualified specialists in maternal and child health centers conduct on-site medical examinations for pregnant women and reproductive-age women. Training sessions and seminars have been organized, and 15 specialists have undergone professional development abroad (13 in Russia, 1 in Poland, and 1 in Turkey). Amid the COVID-19 pandemic, 15 medical institutions have b