Organization of medical care for pregnant women, fetuses and children with critical congenital malformations in a multifunctional perinatal center

Aim - to develop a concept for providing medical care to pregnant women, their fetuses and children with complex congenital malformations in a multifunctional perinatal center, to assess postoperative mortality of patients with critical congenital malformations. Materials and methods. A retrospective analysis of medical records of 437 children was performed, and the levels of postoperative mortality in patients with complex and critical congenital malformations who underwent surgical correction of the defect in the conditions of the SI «Ukrainian center of maternity and childhood of the NAMS of Ukraine» were studied, in the period from 1981 to 2025. Results. The proposed concept of organizing medical care for pregnant women, fetuses and newborns made it possible to reduce the mortality of newborns with congenital malformations: in congenital small bowel obstruction from 37.5% to 11.4% (with high obstruction) and from 56.3% to 26.3% (with low). In diaphragmatic hernia, a decrease in postoperative mortality was noted from 56.6% to 9.7%. In gastroschisis, the total postoperative mortality with both uncomplicated and complicated forms decreased from 63.0% to 14.4%, since 2018 - 0%. Conclusions. The development and implementation of the concept of organizing medical care for pregnant women, fetuses and children with critical congenital malformations in the conditions of a multifunctional perinatal center made it possible to significantly reduce postoperative mortality of patients and achieve mortality values identical to the results of leading world clinics. No conflict of interests was declared by the author.