Women's consultation is a medical institution that receives women, examines them, and treats diseases of a certain nature. What is the structure of the antenatal clinic? What do the experts do? What tasks does this type of institution have and what functions does it perform? Let's consider all this in more detail below.
General concept
Before understanding the structure of the antenatal clinic, the tasks and principles of work, you need to decide what is meant by this concept.
Thus, a women's consultation is considered a medical institution of a treatment-and-prophylactic type, presented in the form of a dispensary. Such institutions are created in order to provide the female half of the population with obstetric and gynecological care on an outpatient basis. In the process of carrying out all actions and medical events, specialists canuse medical technology. In addition, this type of institution conducts activities aimed at protecting the reproductive he alth of women, as well as local specialists provide family planning services.
As for the principle of operation of the considered category of medical institutions, it is a district. Observations of extras and specialists in the field of gynecology show that the section of the antenatal clinic in terms of number corresponds to two therapeutic ones. Having made simple calculations, it is easy to establish that, on average, for one gynecologist who works in the institution in question, there are about 2.5 thousand of the fair sex living in a densely populated region of Russia.
Tasks
As for the main tasks and functions of the antenatal clinic, the main one is to ensure the he alth of women, as well as mothers and children. It is produced mainly by the method of providing professional medical care to gynecologists and obstetricians, and it does not matter at all whether a woman is pregnant or not. In addition, the tasks of this type of medical institution include the provision of reproductive he alth protection.
What are the primary and most important tasks of the antenatal clinic? When considering this issue, one should pay attention to the fact that it is in such institutions that they carry out all kinds of preventive measures that are aimed at preventing problems that may arise during pregnancy or its planning. Besidesspecial attention of specialists is paid to the prevention of diseases in the postpartum period, as well as he alth problems in the field of gynecology, which may not be related to pregnancy.
Provision of professional medical care in the field of gynecology and obstetrics is also among the main tasks of antenatal clinic doctors. In parallel with this, specialists are required to consult on all issues that may arise in women of any age. Their tasks also include holding consultations on issues related to abortion, as well as on sexually transmitted and other sexual diseases.
One of the main goals and objectives of antenatal clinic midwives is to educate representatives of the Russian population about contraceptives. In addition, they should actively work to introduce modern methods of treating diseases and eliminating problems.
If necessary, social and legal assistance can be provided in consultation.
Structure of antenatal clinics
Like any other medical institution, women's consultation must have a certain structure. There is only an approximate list of units of which it may consist. Medical professionals point out that each of the following departments is important, as they provide specialized care for certain issues.
So, in the structure of the antenatal clinic of anythe settlement must have a registry, which keeps a direct record of visitors to specialists, a general list of patients, and also stores all the data entered in personal cards.
In addition to the reception desk, the consultation must have a general department, an obstetrics and gynecology department, as well as an office for an adolescent and pediatric gynecologist.
When determining the structure of the antenatal clinic, one should definitely pay attention to the office, in which there are specialists involved in issues related to family planning, as well as the prevention of unwanted pregnancies. Without fail, the consultation must also include a prenatal preparation room, in which psychoprophylactic procedures are performed with expectant mothers.
Special attention in the structure of the medical institution under consideration should be given to rooms in which certain manipulations are carried out or additional examinations are carried out. These may include departments for endoscopy, x-rays, functional diagnostics, as well as those in which some other specialists are received: a dentist, an oncogynecologist, a venereologist and a therapist. It is mandatory for an institution of this type to have at least two laboratories: clinical diagnostic and cytological.
Due to the specialization of consultations for women, their structure necessarily provides for manipulation rooms, as well as rooms for a young mother.
In addition to all of the above in the women'sconsultations, as in any other medical institution, rooms should be provided for the implementation of economic and administrative needs.
Practice shows that large medical institutions also have additional structural units. In particular, hospitals equipped to treat patients and conduct examinations of those who suffer from gynecological diseases can serve as striking examples of such. Another variant of such a structural element is a department for gynecological manipulations and small operations.
Organization of work
The normal implementation of medical work, first of all, is ensured by the correct creation of the organizational structure of the antenatal clinic. Among its divisions, there must be those that can perform all the necessary functions necessary to maintain the normal level of he alth of the female half of the population in a particular region, provide an appropriate level of theoretical education in the field of family planning, prevention of unwanted pregnancy, as well as sexually transmitted diseases and ways to transmission.
As for the organization of this type of institutions in large cities, in practice, one consultation, which according to various indicators is recognized as the best in the locality, is appointed as the main one. In fact, the structure and functions of the antenatal clinic remain the same, but new ones are added to them - those that are characteristic of an obstetric and gynecological center that provides consulting services to the population. ATsuch medical complexes are actively providing services in the field of traditional treatment of diseases in the field of gynecology that arose at an early age, problems with the endocrine system, as well as infertility.
District participation is the main principle of the women's consultation. It directly affects the quality indicator. This is due to the peculiarity of the organizational structure of the institutions of this nature. First of all, good indicators are due to the fact that in the centers organized according to this principle, specialists who are also directly related to the control of women's he alth work at the same time: a dentist, an endocrinologist, a therapist, etc. So, they closely interact with each other, which allows specialists to comprehensively consider the resulting he alth problem for a particular woman. It is often this factor that makes it possible to register a patient in a timely manner, to ensure the normal state of which this is really necessary. Specialists also share positive statistical indicators regarding the timeliness of establishing a special treatment regimen, registration due to pregnancy, etc. Moreover, in such a situation, according to experts, a comprehensive dispensary observation of the patient is possible.
Generic block
In the structure of antenatal clinics and work with expectant mothers, a special place is occupied by the birth unit. This place consists of several parts: wards (prenatal, intensive care, delivery),children's room, sanitary facilities, operating rooms. In addition, there is also a department for newborns. All children's wards must be equipped in accordance with medical requirements: they maintain the temperature and humidity recommended by the standards, as well as sanitary conditions. Every day, pediatricians should inspect these wards and note the condition of newborns. As a result of all this, the doctor is obliged to inform the mother about the information available regarding the he alth of the baby.
Working with pregnant women
The organization of the structure of the antenatal clinic and the work of this medical institution also provides for certain medical actions for women who are preparing to become mothers. In relation to them, the specialists of the centers are conducting special work aimed at maintaining the he alth status of women and its comprehensive improvement.
In order to ensure all the main goals and objectives of the antenatal clinic, the structure of the institution provides for a team of specialists who carry out not only manipulation, but also psychological work with expectant mothers. They are engaged in the observation of a woman, as well as her fetus. To do this, she must register with the consultation and pass a certain list of tests. Before this, the specialist is obliged to examine the patient, measure her pelvis, abdominal circumference, height and weight. If necessary, additional obstetric studies can be performed, as a result of which the condition is studiedindividual organs.
After the first examination is carried out, the woman needs to visit the consultation again after 10 days. From this moment on, the expectant mother should periodically come to the consultation for observation. In the first 20 weeks, this must be done once a month, and after - twice. In the period that follows after 30 weeks of fetal maturation, a woman needs to visit her assigned obstetrician-gynecologist once a week. In some cases, the frequency of visits to a specialist can be changed, first of all, this applies to the option when a woman suffers from any gynecological disease.
In addition to all of the above, in the process of fetal maturation, a woman should be examined by other specialists. In particular, this is an otorhinolaryngologist, therapist and dentist. After these doctors make their conclusion about the patient's he alth status, on the basis of the general available data, the obstetrician draws conclusions regarding the patient's belonging to any risk group.
At the 15-16th week, a woman can start attending a school for pregnant women, which are also organized at antenatal clinics. The organizational structure of this type of institution also provides for the presence of a psychologist with it. The staff of specialists working in this organizational structure is primarily responsible for the moral preparation of the expectant mother for childbirth.
Gynecology care
When considering the structure and organization of antenatal clinics, attention should also be paid to the main activities thatcarried out by specialists of medical institutions of this type. One of their main areas of work is to serve patients who have gynecological diseases. What is it?
It should be noted that this type of activity is carried out in strict accordance with the basic principle of the work of women's clinics - district. This means that women who need hospitalization and specialized medical care can only be referred to the facility they belong to where they live.
As for the service itself, it is carried out in certain stages. First of all, a person who wants to be examined is sent to the registry of a medical institution. Here he should have a registration card with personal data, complaints made by the patient about his state of he alth.
During the reception, the doctor is engaged in a thorough examination of the patient, draws his conclusions and writes the conclusion in the card. As for the examination, it can be both complex and general or gynecological (using bimanual instruments, mirrors, etc.). In the event that during the examination there are any doubts or suspicions about the development of the disease, the specialist must refer the patient for an additional examination, take tests from her and send them to the laboratory.
As for the additional examination, it is a cytological examination of smears, a biopsy, as well as a colposcopy.
At the receptionthe gynecologist, who is performed in the antenatal clinic, must determine the amount of medical care that is necessary to treat the disease or prevent its occurrence. In particular, surgical manipulations, physiotherapy, injections or taking certain drugs, the use of tampons, etc. can be prescribed for this.
In some cases, patients may be placed in a gynecological hospital. This is done only in cases where the patient needs special treatment, which consists in the use of special equipment, special manipulations, etc.
One of the principles of the antenatal clinic is quality indicators that must be on top. It should be noted that they can be achieved only with the correct prescription of treatment, its urgency, as well as timeliness. In some cases, the patient requires urgent hospitalization, which can also be carried out within the consultation. Hospitalization may also be scheduled.
Gynecology care
The principles of the work of the antenatal clinic provide that all women should receive appropriate qualified specialist assistance. That is why the main tasks of this type of medical institution include the timely detection of diseases in the female half of the population of Russia. To do this, in accordance with medical recommendations, it is necessary to visit a gynecologist at least once a year. During the reception, the specialist conductspreventive examination and, if necessary, refer the patient to another specialist. Such preventive examinations can be performed at home, on call.
In the event that serious diseases or infections are detected during the examination, the specialist is obliged to prescribe a course of treatment for the patient, as well as, if necessary, her hospitalization for the purpose of dispensary observation and therapy using modern methods and equipment.
Abortion Prevention
One of the main tasks of the antenatal clinic in any locality in Russia is the prevention of abortion. The importance of this activity lies in the fact that the correct termination of pregnancy by artificial means is the key to the further normal functioning of the woman's body.
As for the features of this type of activity, it is carried out exclusively with the consent of the expectant mother and only for the period of fetal development, which is no more than 12 weeks. In the event that an abortion is necessary for medical reasons, then the period during which the fetus develops in the womb does not matter.
If it is necessary to perform an artificial termination of pregnancy, the obstetrician must give a referral for this operation. In some settlements (as a rule, in small ones), a family doctor is also en titled to issue this document.
As for the termination of pregnancy in an outpatient setting, this is possible only at very early stages (up to twenty days late) or up to twelve weeks.
On obstetricians working ininstitutions of the type under consideration, is also entrusted with the task of conducting educational work among the fair sex in the field of contraception and other modern methods of preventing unwanted pregnancy.
Quality indicators of consultation work
There are certain criteria by which the level of work of the antenatal clinic is evaluated. The tasks assigned to the institution must be carried out clearly and in the proper form. It should be noted that the level of work of the consultation is determined primarily by the timeliness of registration of pregnant women, as well as the timeliness of their examination. This also shows compliance with the basic principle of the work of the women's clinic - efficiency.
As for the completeness of the examination, the level of work of the consultation on this indicator is determined depending on several factors, calculated as a percentage: the study of pregnant women for the Wasserman reaction, the average number of their visits during pregnancy (the norm is 13-16 times for all time), number of births. In addition, for each consultation, the number of women who did not attend an obstetric examination should be taken into account: under normal circumstances, it should be zero.
Working hours
Speaking about the structure, functions and tasks of the antenatal clinic, one cannot fail to note the peculiarities of planning the working time of individual employees who conduct their activities in separate structuralunits.
Separate rules establish that the working day of any obstetrician-gynecologist should include the performance of three types of activities: receiving visitors, providing specialized home care, and performing other work.
As for outpatient appointments with a gynecologist, it can alternate, as a result of which it is carried out, for example, in the morning and in the evening. For this type of activity, the regulations allocate 4.5 hours of working time per day. If you make a simple calculation, then for an hour of admission, a specialist can examine and advise up to five women.
Home care is the provision of specialized assistance to those individuals who, for whatever reason, are unable to visit a specialist on their own. For this type of work, the doctor is given no more than 5 hours during the working day. The doctor can handle approximately one call per hour.
As for other types of work, this group includes activities related to writing, developing new materials, etc.
Any gynecologist has a midwife in his direct subordination, who should provide him with direct assistance in all types of professional activities. Her duties include compiling a list of those women who live in the allotted area (exclusively those who have reached the age of 15). In addition, she is obliged to prepare documentation, medical instruments necessary for conducting examinations of patients. The midwife is responsible for issuing referrals toexaminations, tests, as well as other medical procedures prescribed by the gynecologist. Specialists of this level can also take part in the provision of direct medical care to patients at home, as well as perform diagnostics.
