Vo
lu
m
e
5,
Fe
br
ua
ry
,2
02
5
,
M
ED
IC
AL
SC
IE
N
CE
S.
IM
PA
CT
FA
CT
OR
:7
,8
9
IMPROVING NURSING PRACTICES IN THE CARE OF PREGNANT WOMEN
Kasimova D.A.
Alfraganus University, Tashkent Medical Academy, School of Public Health
Associate Professor, PhD,
E-
mail:
Qurbonova A.R.
School of Public Health, 1st-year Master’s Student, Тashkent, Uzbekistan.
aqurbonova77@gmail.com
Abstract:
Maternal mortality is an integral indicator of reproductive-age women’s health,
reflecting the impact of economic, socio-hygienic, and medical-organizational factors at the
population level. It also serves as a measure of the effectiveness of maternal and child
healthcare services. This article discusses the work of midwives and junior nurses within
medical teams serving pregnant women, as well as the opportunities available for nurses
today. Additionally, the article provides insights into screening examinations designed to
further improve women’s health. Information is also provided on comorbidities in pregnant
women and the “Healthy Family Room” initiative established in local communities.
Key words
: maternal mortality, medical team midwife, screening, visiting nurse, pregnant
woman, healthy family room, pregnancy-related diseases, amniotic fluid, women’s
consultation center, diabetes mellitus, UNICEF, maternal and child health protection.
Maternal
mortality is a fundamental indicator of reproductive-age women's health and
reflects the population-wide effects of economic, socio-hygienic, and medical-organizational
factors. It also serves as a key measure of maternal and child healthcare service effectiveness.
(1) Access to emergency medical care is critical for many women, as obstetric hemorrhage
is one of the leading causes of maternal death, particularly in cases of hemostatic disorders.
(2,3) The most common cause of pregnancy-related bleeding is premature placental
abruption (11-45%), along with postpartum and early postnatal hemorrhages (24.2%).
Disseminated intravascular coagulation was observed in 10% of cases, with the risk of
significant bleeding being linked to specific clinical conditions.
Proper organization of prenatal monitoring for high-risk pregnant women, timely
hospitalization, adherence to treatment protocols, and the availability of emergency surgical
care are crucial in preventing complications. To ensure this, visiting midwives and nurses
must register pregnant women promptly and ensure that they undergo all necessary prenatal
examinations.
Prioritizing women's health is essential. As part of primary healthcare services, women
aged 35-55 undergo screening programs, including cervical cancer screening every three
years by family doctors. (4)For women aged 45-65, breast cancer screening is conducted
Vo
lu
m
e
5,
Fe
br
ua
ry
,2
02
5
,
M
ED
IC
AL
SC
IE
N
CE
S.
IM
PA
CT
FA
CT
OR
:7
,8
9
every two years, including specialist consultations and mammographic examinations.
Women aged 15-49 undergo annual preventive check-ups, including assessments for
pregnancy contraindications. Specialist consultations and general blood tests are also
included in the screening programs.
Within the patronage system, pregnant women undergo medical examinations by a
medical team midwife at 12 and 32 weeks of pregnancy. Postpartum women are examined
three times—within three days of discharge, and again at 15 and 30 days postpartum. (4)
Breast and cervical cancer, which are the leading cause of death among women and occur
mainly in 35-65-year-old women, are being screened for early detection.(5)
Patronage
midwives play a crucial role in monitoring both maternal and infant health from the onset of
pregnancy, ensuring all necessary medical check-ups, and overseeing postpartum recovery
for 42 days before handing over care to a visiting nurse. Additionally, they educate
communities about healthy pregnancies and childbirth. (6) The government prioritizes
increasing healthcare accessibility, including the establishment of “Healthy Family” rooms
in local communities. These initiatives focus on reducing maternal and child mortality and
preventing hereditary diseases among children. (7) Health Risks During Pregnancy
Pregnancy increases susceptibility to various diseases, especially infections. Infections
affecting the uterus can lead to miscarriage or infertility, highlighting the importance of
timely medical treatment. Early intervention prevents premature rupture of amniotic fluid
and subsequent septic complications. (8) Normally, amniotic fluid is released after 37 weeks
of pregnancy, signaling labor within 24 hours. However, pregnancy-related conditions
affecting the placenta can lead to premature rupture. (8) To improve reproductive health and
medical care for pregnant women, specialized women’s consultation centers and adolescent
health departments have been established. Systematic patronage services and reproductive
health initiatives have proven effective. Advances in gynecological diagnostics, treatment,
and rehabilitation now align with international standards. Qualified specialists in maternal
and child health centers conduct on-site medical examinations for pregnant women and
reproductive-age women. Training sessions and seminars have been organized, and 15
specialists have undergone professional development abroad (13 in Russia, 1 in Poland, and
1 in Turkey). Amid the COVID-19 pandemic, 15 medical institutions have been designated
for pregnant women infected with the virus, with a total capacity of 820 specialized hospital
beds. Stakeholders have also discussed ongoing challenges and proposed improvements in
maternal and neonatal care policies. Deputies have suggested strengthening healthcare
personnel capabilities and revising staffing norms for women’s consultation clinics and
adolescent health centers. Increasing the number of general practitioners and optimizing
workloads would enable better integration of obstetricians, gynecologists, pediatricians, and
adolescent gynecologists in primary healthcare settings. The Role of UNICEF and New
Patronage Models The Ministry of Health and UNICEF have jointly developed a universal
progressive home visit model to improve the quality and accessibility of medical care for
pregnant women and children under five. This model enhances monitoring of child
development and maternal health during pregnancy and postpartum recovery.
Healthcare professionals gathered in Tashkent for a national meeting to discuss the new
patronage model and receive training on risk identification and best practices in maternal
and child healthcare. The new model prioritizes not only medical issues but also social,
educational, and preventive healthcare measures.
Vo
lu
m
e
5,
Fe
br
ua
ry
,2
02
5
,
M
ED
IC
AL
SC
IE
N
CE
S.
IM
PA
CT
FA
CT
OR
:7
,8
9
Conclusion.
Maternal and child health services include obstetric-gynecological and
pediatric care, provided through a network of hospitals, women’s consultation clinics,
perinatal centers, and primary healthcare facilities. Obstetric care is available in urban
maternity hospitals, women's clinics, and rural healthcare centers. (9)Diabetes is one of the
major health concerns during pregnancy, with two primary types: pre-existing (Type 1 or
Type 2) and gestational diabetes. Both forms can pose serious health risks if not managed
properly.
Pre-existing diabetes refers to diabetes diagnosed before pregnancy, while
gestational diabetes develops during pregnancy and usually disappears after delivery. Both
types of diabetes can be dangerous for mother and baby if left untreated. One of the main
concerns with diabetes during pregnancy is the risk of complications such as high blood
pressure, preeclampsia, premature birth and birth defects. Poorly controlled blood sugar
levels can lead to larger-than-normal babies, which increases the risk of complications
during delivery. To manage diabetes during pregnancy, it is important to work closely with
your health care team, which may include an endocrinologist, obstetrician, dietitian, and
diabetes educator. They will help you monitor your blood sugar regularly, eat a healthy diet
tailored to your needs, stay physically active (with modifications as needed), take any
prescription medications or insulin, and exercise regularly. helps create a personalized care
plan that includes prenatal care. inspections. Diabetes and pregnancy can present unique
challenges, but with proper management and medical care; women with diabetes can
successfully conceive and give birth to healthy children. Regular monitoring of blood sugar
levels and following a balanced diet plan recommended by health care providers or
nutritionists are essential.
By educating yourself about the risks associated with diabetes during pregnancy, you can
take proactive steps to effectively manage the condition and have a safe and healthy
pregnancy journey. (10)
Summary
In conclusion, it can be said that through this article you can learn about how nurses
provide services to pregnant women and what they strictly follow. Screening among the
population and the need to ensure the active participation of women and girls aged 15-49 in
particular. Bringing medicine closer to the population - the priority task set by our head of
state is the measures aimed at forming a healthy family, in particular, the establishment of
"Healthy Family" mothers in the neighborhood It plays an important role. It is mainly the
duty of the nurses of the medical brigade to implement this among the population. In
addition, you can learn information about premature rupture of the hymen in pregnant
women and comorbidities of a pregnant woman.
References:
1. Zakirova N, Abdullayeva N. Factors influencing maternal illness and death. //EURASIAN
JOURNAL OF ACADEMIC RESEARCH. 2023.-№241
2. Zakirova N.I. // Materinskaya smertnost v regione s vysokoy rojdaemostyu// Obstetrics
and Gynecology. S. 21-24. 1998
Vo
lu
m
e
5,
Fe
br
ua
ry
,2
02
5
,
M
ED
IC
AL
SC
IE
N
CE
S.
IM
PA
CT
FA
CT
OR
:7
,8
9
3. Zakirova N. Zakirova F. Abdullayeva N. Features of pregnancy management and birth
outcomes in women with fetal macrosomia with active and expectant tactics. Journal of
reproductive health and uro-nephrology research. 2022; 3(4):77-79.
4. Khudoyorov L. What kind of patronage and screening examinations does the midwife of
the Medical Brigade conduct for women? | Khudoyorov L|| Nurse.-Tashkent,-№1.-B.5.
5. Butayev F. NEW MODEL: How should medical brigades work?| Butayev F.||Nurse.-
Tashkent,-№4.-B.12
6. Azimova G. Patronage midwife: incentive, action, result!| G. Azimova|| Nurse.-
Tashkent,-№6.-B.6
7. Gozidinov B. How should the "Healthy Family" rooms be!| B Gozidinov|| Nurse.-
Tashkent,-№6.-B.8
8. Bekchanova A.S. Observation, assessment and comparison of the pregnancy with
premature rupture of the hymen before delivery with last year's results: naunoe izdanie/A.S.
Bekchanova, D.T.Ruzmetova, Z.R.Madaminova:{s.n}| |Sovremennye podkhody k
standardizatsii okazaniya medical assistant in obstetrics and gynecology practice: materialy
nauchno-prakticheskoy conference posvyashchennoy pamyati d.m.n. Professor A.S.
Mordukhovich (Tashkent, February 23, 2023).- Tashkent, 2023.-S16.
9. Akhunova N (2022). Maternal and child health care: a new universal model of patronage
nurses in women's and children's health care. development of pedagogical technologies in
modern sciences, 1(2), 2–4. https://doi.org/10.5281/zenodo.7091366
10. Komiljonova Diabetes and pregnancy: what you need to know O Komiljonova||
Scientific Journal of Biological and Chemical Sciences May 23 / 2024 / Issue 5, pp. 43-44.
