Perinatal and neonatal care
The Russian Federation operates a three-tier system of care for pregnant women and newborns. Its foundation consists of perinatal centers equipped with high-tech medical devices. This enables primary resuscitation (including mechanical ventilation) and successful nursing of premature infants, including those with low and extremely low birth weight.
Priority areas for diagnosis and therapy in the neonatal period include:
- Intrauterine infections (IUI).
- Congenital malformations.
- Hereditary pathologies (managed with the direct participation of medical genetic counseling clinics).
A critical stage is neonatal screening. This is a mandatory mass examination aimed at the early detection of five severe conditions: phenylketonuria, congenital hypothyroidism, galactosemia, cystic fibrosis, and adrenogenital syndrome. Treatment efficacy directly depends on strict routing and continuity of care between the inpatient facility (maternity hospital, perinatal center), outpatient facility (children's polyclinic), and consultative-diagnostic centers.
Basics of prevention and routine health assessment
Preventive care is fundamental in pediatrics. The district pediatrician plays the key role here.
The first stage of routine health assessment consists of preventive examinations. Their main goal is to evaluate the child's physical and neurodevelopment, detect pathologies in a timely manner, and prescribe therapeutic and wellness measures. Examinations are carried out within strictly regulated timeframes defined by Order of the Russian Ministry of Health No. 1346n (this same order regulates examinations prior to admission to kindergartens and schools). Immunoprophylaxis is a separate and extremely crucial component of the preventive care complex.
Neonatal home nursing visit algorithm
During the first month of life, continuous monitoring of the child's health is carried out at home. This task falls upon the district pediatrician and nurse.
The timelines for home nursing visits are strictly regulated:
- Initial examination: performed within the first 2 days after the child's discharge from the maternity hospital.
- Second examination: conducted the day after the initial home visit.
- Subsequent examinations: take place on the 10th and 21st days of the newborn's life.
If there are medical indications, consultations with subspecialists can be arranged directly at home. Additionally, if the child had a medical exemption in the maternity hospital, vaccination against tuberculosis with BCG or BCG-M vaccines may be administered during the home visit.
Comprehensive 1-month examination
Upon reaching the age of one month, the child is examined in an outpatient clinic setting. At this stage, the district pediatrician determines and assigns the health group. This conclusion is made based on the medical history (including the neonatologist's discharge summary from the maternity hospital) and the results of examinations by subspecialists.
At one month of age, the child must be examined by:
- Neurologist.
- Ophthalmologist.
- Pediatric surgeon.
In addition to the clinical examination, instrumental ultrasound screening is performed at 1 month. It mandatorily includes:
- Abdominal ultrasound.
- Echocardiography (EchoCG — ultrasound of the heart).
- Hip ultrasound (for early exclusion of dysplasia).
- Neurosonography (brain ultrasound through the open fontanelle).
The 5 neonatal screening diseases can be remembered by the Russian acronym FAG-MG: Phenylketonuria (Phenylketonuriya), Adrenogenital syndrome (Adrenogenitalny sindrom), Galactosemia (Galaktozemiya), Cystic fibrosis (Mukovistsidoz), Hypothyroidism (Gipotireoz — congenital).
Class and exam questions
When is the initial newborn home visit conducted?
The initial home visit to the child by a pediatrician and nurse is conducted within the first two days after discharge from the maternity hospital.
What conditions are screened for during mandatory neonatal screening?
The mandatory mass screening program includes 5 diseases: phenylketonuria, congenital hypothyroidism, galactosemia, cystic fibrosis, and adrenogenital syndrome.
What instrumental studies are mandatory at 1 month of age?
Instrumental screening includes abdominal ultrasound, hip ultrasound, echocardiography (EchoCG), and neurosonography.
Which specialists examine the child at 1 month of age?
In addition to the district pediatrician, who determines the health group, the child must be examined by a neurologist, ophthalmologist, and pediatric surgeon.
What else to study on this topic
- Three-tier system of perinatal care and patient routing
- Principles of nursing premature infants with extremely low birth weight
- Criteria for determining children's health groups
- Features of neurosonography and hip ultrasound in infants
- Immunoprophylaxis: indications and medical exemptions for BCG vaccination
Master the entire topic in the Pediatrics course
This is a summary. The course covers everything tested in classes and exams.
- Complete study guide on "Organization of Preventive Work and Health Assessment in Children" and 3,738 more subject pages
- Assignments and quizzes after every topic — just like in a colloquium
- AI tutor answers questions on the topic anytime
- 71 video lessons on the subject
Other topics in "Chapter 1. General Issues"
Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.