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The threat of miscarriage or spontaneous abortion is a pathological condition in which fetal loss is possible in the first 22 weeks. The pregnancy can be terminated later, but it will no longer be a miscarriage, but a premature birth. The causes of this condition are very diverse and are often related to the hormonal status of the woman.

According to some sources, chromosomal abnormalities of embryos occupy a leading position among the main causes of abortion.

Warning signs

Harbingers of the threat of miscarriage are 3 characteristic symptoms - pain in the lower abdomen, hypertonicity of the uterus and spotting from the vagina. The pain syndrome can be localized only in the lower abdomen or radiate to the lower back, left or right side, and also have a girdling character.

The type of pain varies from nagging and dull to cramping and throbbing. The pain does not depend on movement, body position, urination or defecation. It does not decrease during moments of rest, but only intensifies.

According to statistics, every fifth pregnancy is terminated in the early stages in the first 3 months, which in figures amounts to 170 thousand miscarriages per year.

Uterine hypertonicity is manifested by thickening of the anterior wall of the abdomen, which rises slightly and becomes more rounded. The uterus is tense to the touch, there may be a feeling of fullness in the external genitalia and perineum. If the tone of the uterus increases in the second trimester, this indicates high excitability of smooth muscles and a real threat of miscarriage.

Discharge with blood is the most dangerous symptom, the appearance of which should be a reason for urgently seeking medical help. With spotting and scanty discharge, there is every chance of saving the baby, subject to timely treatment. Heavy bleeding, especially with clots, poses a danger not only to pregnancy, but also to the health of the mother in general. In this case, it is very important to prevent complications and preserve the woman’s reproductive function.

Hormonal disbalance

This is the most common reason why a pregnancy may be terminated. The level of the hormone progesterone is of decisive importance, which decreases with insufficient phase of the corpus luteum, hypothyroidism, existing tumors and ovarian cysts. Progesterone is necessary to suppress spontaneous uterine contractions; if there is a lack of it, the uterus begins to contract and literally pushes out the fetus.

Progesterone synthesis decreases with an increase in prolactin production against the background of hormone-dependent pituitary tumors.

The threat of miscarriage is also possible with high levels of androgens - hyperandrogenism, due to which the fertilized egg may not be retained in the uterus.

Isthmic-cervical insufficiency - ICI

This term refers to premature shortening of the isthmus and cervix, leading to the inability to withstand intrauterine pressure and retain the growing fetus in the uterine cavity. The cause of this condition is abortion, including spontaneous childbirth and diagnostic curettage, undergone by a woman before pregnancy.

Throughout pregnancy, a woman experiences a wide variety of sensations. Some of these may be symptoms of an impending miscarriage.

Symptoms of ICI most often occur towards the middle of the term, and the pregnancy ends. To prevent such an outcome, it is preferable to use a non-surgical correction method, in which special support devices - silicone or plastic pessaries - are inserted into the vagina.

Chromosomal mutations

More than half of all miscarriages occur precisely due to chromosomal mutations of the fetus. Such genetic failures can lead to gross malformations of the fetus, which make it unviable. It makes no sense to continue such a pregnancy, since this is a kind of natural selection.

It is worth noting that genetic mutations are not hereditary in nature, but are formed in the germ cells of parents under the influence of harmful factors - radiation, industrial intoxication, viruses, etc.

Immune disorders

This is, first of all, a Rh conflict, when the Rh factors of the mother and father do not match. The mother's body begins to produce protective antibodies, which in certain concentrations can cause fetal rejection and create a threat of miscarriage.

The immune factor is also triggered in the case of consanguineous marriages, when the mother’s body rejects the fetus, mistaking its cells for foreign ones.

Mother's illnesses

General and gynecological pathologies, as well as sexually transmitted diseases, can create a threat of premature termination of pregnancy. Increased risk factors include the following diseases:

• rubella, viral hepatitis, influenza are the most common and potentially dangerous viruses for the unborn child;
• sore throat, pneumonia;
• pyelonephritis;
• appendicitis;
• antiphospholipid syndrome;
• polycystic ovary syndrome;
• endocrine disorders;
• abnormal development of the genital organs (bicornuate uterus, uterus with septum, duplication of the uterus);
• high degree of obesity;
• history of abdominal trauma;
• syphilis, trichomoniasis, chlamydia, toxoplasmosis and other common sexually transmitted diseases;
• herpes, cytomegalovirus.

Separately, it should be said about age. The risk of spontaneous abortion increases after 40 years by almost 41%.

Medicines and herbal medicine

During pregnancy, special care should be taken when taking medications. It is ideal not to take them at all, but if necessary, consult a doctor and take the safest means. Cytostatics (for example, Methotrexate), anticoagulants: Phenilin, Neodicoumarin, Warfarin, Sincumar can provoke a miscarriage. The drug Ergotamine, which is used in obstetric practice to stop uterine bleeding, sharply increases uterine tone.

If treatment is necessary, be sure to consult a doctor

Herbal medicine can be no less, and sometimes even more dangerous, than medications. Some herbs have teratogenic, carcinogenic and toxic effects. The list of prohibited plants includes thyme, juniper, hops, mint, rosemary, tansy, wormwood, etc.

How is the diagnosis made?

The most important diagnostic method is ultrasound, which allows you to monitor the progress of pregnancy and promptly identify emerging pathologies. Ultrasound can establish increased uterine tone, abnormal heart rate, underdevelopment of the chorion and the presence of retrochorial hematoma.

When making a diagnosis, the fetal heart rate must be taken into account. His heart begins to beat from 5 - 6 weeks, and until birth, the number of beats per minute is 140 - 160. The deviation of these indicators in one direction or another can be critical. There will be a threat of miscarriage when the number of contractions decreases to 100 or increases to 200.

Retrochorial hematoma is usually detected during a routine ultrasound, when there are no symptoms yet. Otherwise, the pregnancy may be terminated. If the chorion is underdeveloped, the fetus may die due to malnutrition.

Therapy methods

Therapeutic measures differ at different times and are carried out over weeks. In the first 3 months, a woman needs moral support, a gentle regime with minimal physical activity and sexual rest.

If necessary, drug treatment is prescribed, which may include the following drugs:

• Duphaston, Prajisan, Utrozhestan, replenishing progesterone deficiency;
• Valerian, Motherwort in the form of dragees or tinctures;
• Magnelis B6 is usually drunk according to the following scheme: 1 tablet in the morning and afternoon, 2 at night;
• rectal suppositories with Glycerin, Mirolax microenemas to normalize stool.

The presence of bloody discharge is an indication for treatment in a hospital, where tranexamic acid TXA is administered intravenously. Additionally, it can be prescribed in tablets.

If the pregnancy is more than 12 weeks, tocolysis is mandatory - the contractile activity of the uterus is suppressed. For this purpose, infusions of magnesium sulfate 25% - magnesia are used. Thanks to magnesium treatment, it is possible not only to normalize uterine tone, but also to remove swelling due to its diuretic effect.

In most cases, pregnancy can be saved if treatment is started on time.

The most important

Every pregnant woman should know what to do in the event of a clear threat of miscarriage. When the first suspicious signs appear (pain, blood, abdominal tightness), you must call an ambulance. Before the doctors arrive, you are allowed to drink No-shpa or insert a rectal suppository of Papaverine.

According to statistics, every 10 pregnancies end in fetal rejection.

In most cases, the woman does not even suspect this, since a miscarriage occurs a few days after conception, when the fact of pregnancy is not established.

However, there are risks of embryo rejection at a later stage.

The risk of miscarriage is the risk of spontaneous abortion.

An early miscarriage is considered to be a pathology that occurs during the first 12 weeks after conception.

The critical period is 2-3 weeks, when the chorion is implanted into the endometrium of the uterine wall. At this time, it makes sense to talk about biochemical pregnancy.

The body may mistake the embryo for a foreign body and provoke its rejection.

A smear is taken from 3 places: the mucous plug of the cervix, the urethra, and the epithelial layer of the vagina.

The samples are dried, first placed on glass, and examined under a light microscope, staining the material with contrast agents.

A set of tests is considered a guarantee of identifying a threat of miscarriage

• Hormone analysis.

It is carried out to identify a deficiency or excess concentration of hormones such as prolactin, testosterone, progesterone, substances produced by the thyroid gland. A change in the normal level is a warning about the threat of miscarriage.

• Analysis for the presence of antibodies to lupus anticoagulant and hCG.

For a number of reasons, a woman’s body can produce antibodies to hCG, human chorionic gonadotropin, which is necessary for the normal course of pregnancy. In this case, the risk of spontaneous abortion increases significantly.

In addition, the blood is tested for the presence of antibodies to the lupus anticoagulant.

Their presence does not necessarily indicate the presence of lupus erythematosus, but makes it possible to identify an infectious process and decreased immunity.

• Analysis for Rh factor.

Every woman's Rh factor is determined during pregnancy. A positive Rh of the child and a negative Rh of the mother lead to a conflict, which is difficult to accurately predict, since it is almost impossible to take a fetal blood sample for research.

However, the conflict between the Rh factors of mother and child is accompanied by the formation of antibodies, which can be detected by analyzing a blood sample.

• Analysis for intrauterine infection.

A blood test to detect pathogens such as cytomegalovirus, toxoplasmosis, rubella, and herpes also helps determine the cause of a miscarriage or prevent its threat.

If the diagnosis is confirmed, treatment should be carried out in an inpatient department.

How to prevent the threat of miscarriage: what treatment can a doctor prescribe?

Throughout the treatment, the woman should be at rest, avoiding physical exertion and emotional stress.

Sex when there is a threat of miscarriage is contraindicated.

As a rule, a veto on intimacy is imposed by the patient’s attending physician. And only a specialist can remove this restriction when he considers that the danger has passed.

The following measures are used to prevent fetal rejection:

• administration of hemostatic drugs to block bleeding;
• the use of vitamin therapy to improve the general condition of the woman and fetus;
• maintenance hormonal therapy. If there is a threat of miscarriage, pills are prescribed or if a hormonal imbalance is detected to normalize progesterone levels;
• Treatment of threatened miscarriage is also aimed at reducing uterine tone and pain with the help of antispasmodics: no-shpa, intravenous magnesium.

Since the blood supply to the fetus deteriorates, special means are used to normalize it: Actovegin, and others.

Personal experience

I had to face the diagnosis of “threatened miscarriage” only once - during my first pregnancy. At 7 weeks, spotting appeared. At first the discharge was very pale, even pink, but then it became.

The bleeding was not severe - only a few drops, but this was the reason for going to the hospital. Moreover, I had no other symptoms: pain, tone, etc. First, I called the doctor and described the symptoms. Then it was decided to go to the gynecologist.

There they processed me and scheduled an ultrasound for the next day to rule out a miscarriage and see if the fetus is developing. By this time there were no longer any discharges. But I was in the hospital. Treatment has not yet been prescribed either.

I had an ultrasound in the morning. They did it with a transvaginal sensor. The doctor was not in a good mood, there were many pregnant women, and she looked very painful. I will say more, this was the most painful examination of all the transvaginal ultrasounds I have done in my entire life.

Ultrasound revealed no pathologies, the heartbeat is normal, the fetus is developing. After the ultrasound, I began to smear scarlet blood, which really scared me. Apparently there was no need to go inside and conduct an abdominal examination. I told the doctor about this. She advised me to lie down more and prescribed treatment: , and Duphaston, 1 pc. at night for 2 weeks.

Treatment began on the same day. There were no more allocations. After 8 days I was discharged and I finished Duphaston at home. This problem did not arise again, and my first pregnancy ended in a successful birth.

Ksenia, 35.

How to maintain pregnancy: preventive measures

1. To prevent the threat of miscarriage, it is advisable to undergo treatment for chronic diseases.
2. It is necessary to get rid of bad habits, move more, and avoid stress.
3. Under unfavorable working conditions, it is better to switch to light work.
4. You need to adhere to a reasonable daily routine and undergo timely examinations prescribed by the gynecologist.

The threat of miscarriage is not a final death sentence. Most often, it is possible to maintain a pregnancy if you inform your doctor about it at the first sign of discomfort.

Since the time of Paracelsus and other alchemists, science has taken medicine to a fundamentally new level. In countries where medicine develops in accordance with the development of technology, patients do very well. High technologies are directly involved in the process of treating people, monitoring them, and huge amounts of money are invested in them. Of course, this has a beneficial effect on the healthcare sector as a whole in any country in the world. Medical equipment is expensive, but over time it is becoming more accessible and popular even among the most conservative. The results speak for themselves.

Main materials

What did a person look like who lived in Europe long before the construction of the Egyptian pyramids? Setting out to find the answer to this question, scientists analyzed and completely reconstructed the genome of an ancient girl who lived in the territory of modern Denmark about 5,700 years ago. To carry out the reconstruction, the researchers only needed the presence of a small piece of birch resin, which for many millennia immortalized the imprint of the teeth of a human being who lived on the Danish island of Lolland.

Science always amazes with its new discoveries, turning things that one could only dream of into real working inventions, which we, in turn, often take for granted in a world of frantic rhythm. Especially, which is developing at such a speed that some of the same things we are used to seeing in science fiction films will soon find their way to the healthcare system. All of these innovations have the potential to change the face of the healthcare industry and the lives of millions of people.

From human head transplants and cancer traps to new treatments for depression, all these medical changes will become a reality in 2017. If some of the innovations seem crazy, remember that once upon a time video communication, smartphones and space travel were only the pages of science fiction books.

15. Fast healthcare with compatible resources

Many health insurance departments and companies around the world have been under enormous pressure for many years. Some of them are already close to closing due to a pointlessly complicated system. As a result, patients experience excruciating delays when it comes to paying medical bills or making routine doctor appointments.

Thanks to the BZSR, the health care system will function much more easily. The BZSR will act as a translator between the two health care systems. This will help streamline the clinical data return process. Why is this so revolutionary? Because more life-saving data can be shared across departments, which means more lives will be saved. You may be interested in the article 10 myths about homeopathy.

14. Wireless health monitoring

Smartwatches can track your fitness level and help you stay fit. But what about technology that you can carry with you everywhere and that can also save your life? In 2013, a team of Swiss biologists developed an implantable device that could monitor substances in the blood and send this data to a phone. Researchers hope that the device will be ready for sale by 2017.

The device is 14 mm long and its surface is partially coated with an enzyme that will be able to detect chemical elements such as glucose and lactate. Essentially, this thing can track in real time and may be able to warn a patient of a heart attack hours in advance. Despite the fact that the device is at the development stage, the potential of this mini-laboratory is amazing.

13. Improved car safety and driverless models

If the idea of ​​driverless cars is scary, think about the horrific statistics involving cars with a driver at the steering wheel. More than 38,000 car accidents each year result in death or disability.

Luckily, car safety is getting smarter every day. Whether there will be driverless cars or not, one thing is certain - your four-wheeled friend will take care of your safety. Automatic features like collision warning sensors, softer cruise control and anti-sleep devices will find their way into cars released in 2017. Slowly but surely, safety technology is aiming to remove the human element from driving.

12. Dental regeneration

By 2017, rotting and falling teeth can be regenerated. A team of Japanese cytologists at the University of Tokyo has demonstrated tooth regeneration in mice, and they now believe that with further research, this technology could be made available to humans.

Using a combination of stem cells and specific dental germs from mouse embryos, the team successfully grew a new tooth in a mouse's jaw in 36 days, complete with roots, pulp and outer layer of enamel - just like a real one! Once the procedure is available, it will cost a considerable amount of money.

11. Microbiome

The gastrointestinal tract is home to trillions of bacteria that create a community called the microbiome. What's both scary and great here is that these germs can release chemicals into the body that interfere with food digestion, response to medications, or help spread disease.

10. Diabetes medications to reduce heart disease

For decades, diabetes has been a major problem. People with diabetes are twice as likely to have heart disease or suffer a stroke than those who don't. However, thanks to medications, patients have a better chance of living a long, healthy life with diabetes.

9. Liquid biopsy that looks for cancer

Typically, to find cancer cells in the body, a biopsy is used, which involves collecting a large amount of tissue from the patient. Fortunately, a less painful and expensive form of biopsy is on the way. A liquid biopsy is a blood test that will show signs of cancerous DNA.

This incredible leap means that cancer could soon be detected through cerebrospinal fluid, body fluids, and even urine. New tests will be carried out next year. With advances like these, it's not that hard to imagine a world without cancer.

8. Chimeric antigen receptor T-cell therapy for leukemia

Chimeric antigen receptor– a form of cellular immunotherapy. It represents an incredible breakthrough for leukemia patients. The therapy involves removing T cells and genetically altering them to target and destroy cancer cells.

Once the cancer cells are destroyed, the T cells remain in the body to prevent recurrence. This unique treatment could end chemotherapy in the future and may even be able to treat advanced stages of leukemia.

7. Bioabsorbable stents

600,000 patients have metal stents implanted to treat blocked coronary arteries. Once the artery has widened, the stents remain in the body forever. In rare cases, they can cause blood clots, ironically defeating the whole purpose of the stent itself.

Fortunately, a new self-dissolving stent will allow patients to rely less on medications for blockages. This new stent is made from a naturally dissolving polymer. It dilates arteries like regular stents, but remains in the body for two years before being absorbed internally.

6. Treatment of depression with ketamine

Even in 2016, we don't know much about depression and the various effects it has on people, making it an even more severe illness. A third of patients do not respond to traditional medications due to lack of research and development, costing lives.

However, a ray of hope exists in the form of ketamine. Formerly known as " party A drug, ketamine contains properties that are aimed at inhibiting NMDA receptors in nerve cells. These receptors are extremely responsive to symptoms of depression. Studies have already shown that 70% of patients with drug-resistant depression noticed improvements in symptoms after 24 hours.

Such successful effects of ketamine on patients have already prompted the development of other drugs targeting NMDA to increase the availability of more effective treatments for depression in 2017.

5. HPV self-testing

HPV is responsible for 99% of cervical cancer cases. And the worry here is that many women around the world may be at risk of dying from cervical cancer even without the ability to get diagnosed.

Currently, HPV prevention and treatment is limited to women with access to HPV testing and vaccines, leaving women completely in the dark when it comes to identifying the dangerous virus. Fortunately, scientists plan to increase peace of mind for women in 2017. Self-testing for HPV will allow patients to send samples to a laboratory.

4. 3D aids in surgery

Surgery is incredibly complex at the best of times, but for eye surgeons and neurosurgeons it is even more difficult because they are timed to the minute. In these cases, attention to detail is a matter of life and death. Many surgeons must perform jewelry work for hours with their heads bowed and looking through a microscope, which puts constant strain on their back and neck.

This approach to work is not productive for both the surgeon and the patient. This is why new 3D cameras have been developed. They assist surgeons and their colleagues during complex operations. These 3D cameras create holographic anatomical aids that allow surgeons to work more comfortably. Rishi Singh, a surgeon at the Cleveland Institute of Eye Microsurgery, has been working with the new technology for 6 months. He notes that this widens the field of view and provides greater comfort. Knowing that the surgeon is comfortable, the patient himself will feel more confident.

3. HIV vaccine

Between 1983 (when HIV was first described) and 2010, the HIV/AIDS virus claimed the lives of more than 35 million people around the world. Many people are living with this virus. A working HIV vaccine is seen as the holy grail. Extensive testing of the vaccine, which appeared in 2012, is fortunately leading ever closer to this very holy grail.

The 2012 vaccine, known as SAV001, was successfully tested in experimental animals and has now entered the human testing phase in Canada. The vaccine was administered to women and men from 18 to 50 with positive results. Patients did not experience any side effects or reactions to the injections and even showed an increase in immunity. The vaccine had positive results in phases 2 and 3. It is hoped that it will be commercially available in 2017.

2. Treatment of prostate cancer with FUVI

Prostate cancer is the second leading cause of male cancer-related death in men over 50. What makes prostate cancer deadly is that it spreads very quickly to other parts of the body, including the bones and lymph nodes.

Fortunately, survival rates from prostate cancer are increasing, thanks to new effective forms of treatment. FUVI was used in a 2012 study in which cancer cells were killed and 95% of participants were cured after 12 months. FUVI targets cancer cells the size of a grain of rice and heats them to 80-90 degrees. This effectively kills cancer cells in one area without damaging healthy tissue nearby.

Since then, more testing has been carried out with similar successful results. The treatment is set to be offered worldwide in 2017, potentially saving the lives of thousands of men every year.

You have heard about hair and face transplantation. Now an ambitious Italian surgeon wants to attempt the first human head transplant. Sergio Canavero even has a volunteer for the incredibly risky and complex procedure, 31-year-old Russian man Valery Spiridonov, who suffers from muscular dystrophy and has been wheelchair-bound his entire life.

The record-breaking operation will take place in December 2017. The procedure will involve 150 medical personnel and will take about 36 hours, during which the donor's head and body will be frozen to -15 degrees to prevent cell death.

Due to his poor condition and limited life expectancy, Spiridonov considers the risk worthwhile. Let's hope Dr. Canavero can pull this off... (and put everything back together correctly).

Telemedicine opens up fundamentally new opportunities for regions

The future of healthcare IT is now being created in the regions. Unfortunately, lack of funding leads to the fact that the level of their informatization differs significantly. However, new technologies are coming to the market that make it possible to unite all participants in the process of providing medical care. Ekaterina Ustimenko, general director of the Health Technology company, spoke about such technologies in an interview with CNews.

CNews: Information technologies are actively being introduced into healthcare throughout the world. What foreign experience can be identified as a model for Russia?

Ekaterina Ustimenko: The degree of informatization of healthcare in many countries is far ahead of domestic medicine. The UK can become a model for Russia, where more than half of primary care medical institutions are already connected to a unified information system.

In the UK, as in Russia, the provision of primary outpatient care is organized on a territorial basis, but when changing place of residence and, accordingly, general practitioner, a unified electronic medical record allows you not to lose valuable clinical data.

An analogue of this solution, implemented within one region, is EMIAS in Moscow.

CNews: What prevents the implementation of an analogue of the Moscow EMIAS throughout Russia?

Ekaterina Ustimenko: There is a Uniform State Health Information System - the Unified State Information System in the field of healthcare, but to be frank, it is primarily intended for obtaining analytics and statistics. Its clinical value is secondary.

In addition, Russian healthcare is not holistic. Compulsory medical insurance funds are regional, each region has its own ministry of health, which, although it follows federal standards, does so with varying degrees of success, which leads to heterogeneity in the level of informatization of the country's health care as a whole.

CNews: Medicine is a complex field, it is related to the health and life of people. The digitalization of medicine brings with it not only new opportunities, but also risks. What changes in legislation in this area have occurred recently?

Ekaterina Ustimenko: As you know, a bill on the use of information and communication technologies in the healthcare sector has been submitted to the State Duma, which amends a number of federal laws, including 323-FZ. The new bill will significantly increase the importance of healthcare informatization and increase the size of the market as a whole. Electronic document flow is equal to paper document flow, positions on electronic prescriptions have been clarified.

However, the patient authentication schemes it describes may limit the scope of potential users. The bill also implies the possibility of remote doctor-patient consultations, but does not introduce the concept of remote interaction between a paramedic, midwife or nurse with a patient.

CNews: How far has Russia progressed towards the implementation of IT in medicine? What trends can be identified now?

Ekaterina Ustimenko: According to the Ministry of Health, today in Russia 65% of doctors’ jobs are automated. 26% of medical institutions have achieved a fairly high level of informatization - they have introduced electronic medical records, organized their interaction with laboratory and radiological systems, analytical systems and decision-making systems. The main work is currently aimed at creating a unified information space and implementing the possibility of data exchange within the Uniform State Health Information System. At the same time, we see plans to expand the functionality of the “citizen’s office” on the unified government services portal.

The main trends include the personalization of the approach to the provision of medical care, the expansion of the usual framework for the provision of medical services exclusively within the walls of a medical organization, the increasing role of the patient in the process of protecting their health, as well as the increasingly widespread dissemination of solutions aimed at maintaining health in everyday life.

CNews: Data about the health of each person is a very sensitive area. What data protection measures do you think are sufficient?

Ekaterina Ustimenko: Electronic interaction between doctors and patients entails strengthening measures to protect personal data. Now the technologies for their protection and user authentication are standardized and are necessarily built into information systems that connect the doctor and the patient or store medical information. The range of such technologies is clear: firewalling, data segmentation, encryption, multi-factor authentication, electronic signature.

However, to get a noticeable effect, comprehensive protection is necessary. At the same time, the system must remain user-friendly. When creating Medcard 24, we initially thought through security mechanisms at the architectural level, which was confirmed by a security certificate.

Also, we must not forget that data protection is ensured by the culture of interaction as a whole, digital literacy, and not just by organizational measures. It is no secret that now participants in doctor-patient interactions send medical data through regular instant messengers and by email. At the same time, everyone knows that this is dangerous. As telemedicine systems develop, the doctor-patient interaction will become more secure.

CNews: How is IT changing medicine?

Ekaterina Ustimenko: For healthcare organizers, information technology is, first of all, a tool for analyzing and optimizing work, reducing costs and downtime, the ability to quickly generate reports and control the quality of services provided.

For a doctor, this is a tool that allows you to reduce the time required to fill out documents, quickly obtain data on the patient’s research results, and use reference information.

The patient receives better medical care due to increased control over its provision, has the opportunity to exchange information with the doctor, including remotely, and get a second opinion. Collection and processing of clinical data and research results make it possible to improve treatment algorithms and prescribe the optimal course to the patient depending on his characteristics.

CNews: The popularity of personal remote health monitoring devices is growing. What new opportunities do they open up?

Ekaterina Ustimenko: First of all, I would like to note that the popularity of various wearable devices for maintaining a healthy lifestyle is growing significantly. However, their use has not found wide application in clinical practice.

At the same time, there is a tendency to “mobilize” more professional equipment. A number of electrocardiographs and cardiac monitors have appeared on the market, which allow the results to be transmitted remotely to a medical specialist. An example of the transformation of a professional solution into a personal one is a portable urine analyzer integrated into our Medkarta 24 platform. There are devices that allow you to measure blood glucose levels, do biochemical and general blood tests.

CNews: Who, in your opinion, is the leader in the field of IT implementation - government, departmental or private clinics?

Ekaterina Ustimenko: The leader, obviously, was and remains the public sector. The vast majority of implementations of information systems, of course, occur in government agencies.

CNews: What problems arise in the field of healthcare informatization in the regions?

Ekaterina Ustimenko: The implementation of IT in healthcare at the regional level has been going on for a long time; almost all subjects of the Federation are in one way or another optimizing the management of medical institutions and patient flows, as well as healthcare costs in general. In many regional medical institutions you can make an appointment through centralized services.

Almost all regions have been implementing systems for remote interaction “doctor-to-doctor” since the early 2000s, and today many hospitals have specialized rooms in which equipment is installed to provide remote consultations for employees of paramedics and midwifery stations and small medical institutions.

The introduction of telemedicine - that is, the ability to remotely transmit medical information and conduct doctor-patient consultations - opens up new prospects for healthcare at the regional level. Remote medicine can reach every patient, and the regional Ministry of Health will have the opportunity to control all healthcare of the subject.

All this, of course, will require a lot of work from the constituent entities of the Federation - making changes to legislation, medical and economic standards, management practices, and retraining personnel. Some regions are already implementing pilot projects on the use of telemedicine. We believe that this is the only correct approach. When amendments to legislation are approved, regions will be given deadlines for implementing new solutions, and it is better to prepare for this in advance.

CNews: It is obvious that medicine is a very expensive field. How are IT projects financed?

Ekaterina Ustimenko: It is obvious that public health care prevails in Russia, and the main source of financing for most IT projects is the state budget. Private medicine has fewer resources, but is more interested in reducing costs, so it quickly introduces innovations. For example, private clinics today actively use remote appointments with a doctor and mobile applications.

But the main money comes from the insurance business and pharmaceutical companies. And if insurers are already ready to invest in digitalization, the pharmaceutical business remains aloof from this process. And we need to find a way to force him to do this - then really big money will come into medicine, and the industry will take off.

CNews: What barriers to the digitalization of medicine do you see now?

Ekaterina Ustimenko: The main problem is finding sources of financing. In addition, a number of clinics, even after introducing MIS, do not use them fully, that is, the degree of penetration of information systems into daily activities for a number of reasons, including low digital literacy, remains low.

There is a lack of unified regulatory and reference information, although work in this direction is being carried out more than actively. The format and standards for the exchange of clinical information have not been adopted. Because of this, medical institutions that have implemented MIS cannot fully interact with other participants in the process. All this makes it difficult for the industry.

CNews: What solutions does Health Technology offer as an IT developer for medicine and healthcare?

Ekaterina Ustimenko: Our Medcard 24 platform is a solution that allows you to unite all participants in the process of providing medical services. First of all, the patient and the doctor. We strive to collect in one place all information about the patient, the history of his illnesses and treatment, the results of laboratory tests and diagnostic procedures.

Telemedicine plays an important role in this, not only simple consultations in the form of video conferencing or correspondence with a doctor, but also solutions for monitoring chronic patients. Thus, our platform is a ready-made solution for the development of a wide range of medical services.

CNews: How is it different from other solutions?

Ekaterina Ustimenko: Our main goal is not to organize a formal consultation between a doctor and a patient to achieve a short-term effect or simple lead generation, but to create a health monitoring tool that will be useful for the doctor and patient on an ongoing basis.

In addition, we have our own medical center as the foundation of the entire system. The system itself is based in its own secure data center.

CNews: How do you see IT evolving in healthcare?

Ekaterina Ustimenko: The rules of the game in this area are, of course, dictated by the state. At the same time, a large number of participants are involved in the process of providing medical care, in addition to the doctor and the patient. These include health care organizers, insurance companies, employers interested in optimizing labor safety, and executive and supervisory authorities. The rapid exchange of information between them within the boundaries designated by regulations helps reduce costs and allows for more rapid decision-making, which ultimately benefits everyone, and primarily the patient.