Algorithm of management actions for the formation and implementation of a resilient health care quality system.

OBJECTIVE: Aim: Development of an algorithm of management actions for the formation of a resilient system of quality of medical care in health care institutions of obstetric and gynecological profile and formalization of its closed structural and logical scheme. PATIENTS AND METHODS: Materials and Methods: A set of theoretical approaches of social medicine and methods of business process reengineering is used, taking into account the dominant ones: systemic and integrated approach and alarm and process approaches; the concept of resilience; quality of medical care; reproductive health care using business ecosystem methods. RESULTS: Results: The algorithm of management actions for the formation of a resilient system of quality of medical care in obstetric and gynecological health care institutions, which is formalized in nine stages: analysis of needs and identification of problems; substantiation of performance requirements; development of a health care quality strategy; involvement of stakeholders; formation of a system of relative indicators; development of an action plan; implementation of a set of measures; monitoring and evaluation; improving the quality of health care. CONCLUSION: Conclusions: The results made it possible: construction of a closed structural and logical scheme of management actions, taking into account the combination of factors of influence, harmonized with the main functions of the resilient system, which determine the peculiarities of its functioning; justification of the boundaries of managerial and social responsibility of management entities according to the binary components of the medical and social justification of the process of improving the quality of medical care.

PLACENTAL MOSAICISM: COMPLETE DISCORDANCE BETWEEN THE PLACENTA AND THE FETUS. CLINICAL CASE RECORD.

NIPT with the analysis of all chromosomes for aneuploidy screening. Chromosomal microarray 750K, routine karyotyping and Whole-exome sequencing and Sanger sequencing were used for the analysis of the clinical situation Sonographic fetal abnormalities were accompanied by the placental mosaicism (trisomy 16), fetal partial uniparental disomy of the short arm of chromosome 16. NIPT with the analysis of all chromosomes is a powerful tool to identify placental mosaicism, which in turn can manifest itself as nonspecific abnormalities in biochemical markers, placental dysfunction, growth retardation, fetal malformations, preterm birth, etc. If placental mosaicism is suspected, the optimal clinical strategy is to perform amniocentesis and placentocentesis simultaneously with a complete genetic examination of the obtained material.

MODERN EPIDEMIOLOGICAL ASPECTS OF THE PROBLEM OF UROGENITAL MYCOPLASMIS AMONG THE FEMALE POPULATION OF UKRAINE.

OBJECTIVE: The aim: To study and analyze the dynamics, age, and regional characteristics of the incidence of urogenital mycoplasmosis in Ukraine during 2014-2019 and to substantiate medical and organizational approaches to improving the prevention of urogenital mycoplasmosis among women. PATIENTS AND METHODS: Materials and methods: To study the dynamics, age, and regional characteristics of the prevalence and incidence of urogenital mycoplasmosis in women, reference and statistical materials of the State Statistics Service of Ukraine, reference materials and data from reporting forms No. 9, 34, 35 of the Center for Medical Statistics for 2014-2019 were used. RESULTS: Results: The current trends in the dynamics of the incidence of urogenital mycoplasmosis among female population in Ukraine during 2015-2019 are determined, its age features are established, the regional distribution of administrative territories of Ukraine according to the incidence of urogenital mycoplasmosis is substantiated, medical and organizational approaches to improving menopause among women are substantiated. CONCLUSION: Conclusions: The results of the study showed that although urogenital mycoplasmosis is most often diagnosed among women of childbearing age, the risk of infection exists for women of all ages, which indicates the urgency of providing effective measures to prevent it.A wide range of regional indicators of incidence of urogenital mycoplasmosis in women was established: from 0.9 per 100 thousand female population in the Zakarpattia region to 230.9 per 100 thousand in Kharkiv region, with in excess of the average Ukrainian indicator in a number of oblasts by1.8-3.2 times. There is a tendency towards redistribution during 2010-2018 of the age structure of patients with urogenital mycoplasmosis: against the background of a slight decrease in the proportion of age groups from 0 to 14, 15-19, 20-29 years there is an increase in the proportion of other age groups, but the first rank place, as in previous years, is retained by the age group of 20-29 years: 48.4% in 2010, 39.1% in 2018). A statistically reliable correlation connection between age and the level of incidence of urogenital mycoplasmosis among women is not revealed.