Improving the Perinatal Monitoring System and Optimizing Therapeutic and Diagnostic Tactics at The Regional Level

Background: ongenital obstructive uropathies (OU) significantly contribute to neonatal morbidity. This study aims to evaluate an improved three-tier regional model of perinatal monitoring adapted for the Samarkand region. Methods: A prospective study was conducted (2020–2026) involving the development of a "Prognostic Screening Sheet" based on maternal risk factors (OR analysis) and a standardized "72-hour rule" for postnatal ultrasound. Results: The implementation of the model reduced the average age of surgical correction from 8.5 \pm 2.1 to 3.2 \pm 1.4 months. Early decompression in critical cases (e.g., posterior urethral valves) was shifted from day 25 to day 3 of life. Nephrectomy rates decreased by 18% , and hospitalizations for acute pyelonephritis in the first year dropped by 32%. Conclusions: The transition to a "fetus as a patient" paradigm and the integration of obstetric and pediatric services ensure organ-preserving outcomes and prevent early-stage chronic kidney disease.

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