Alexander Boukhtin is a physician at the Volgograd Regional Clinical Perinatal Center in charge of the high risk unit for pregnant mothers. As the director of international relations at the Center, he is the principal contact with GCVOA and MetroHealth physicians. He was in Cleveland during the third week in November 2001 to observe the training for the first of the Volzhsky physicians here this year and to review matters of mutual concern with physicians from MetroHealth’s neonatal and obstetrics department as well as with GCVOA

Let me say some words about Volgograd region. The territory of our region is 114 thousand square kilometers with a population of more then 2.6 million people. The Volgograd region has 33 districts. The Perinatal Center in Volzhsky has responsibility for 9 of these 33 districts, including the highest risk infants born in the Central district hospitals of these districts. All of these districts are in the east central and east southern part of the Volgograd Region. We also now have an affiliated Perinatal Center in Mikhailovka that has similar responsibilities, under our supervision, for an additional 9 districts in the north and northwest. To bring infants requiring special care to Volzhky, we have an ambulance that travels as far as 350 km. Next year we hope to have two more affiliated Perinatal Centers, one for the Southern part and another one for the Northwest part of Volgograd Region.

I would like to give you some statistics that bear on our joint work. The Perinatal mortality rate (rate of infants dying who are at 25 months gestation or more) in the Volgograd region last year was 12.1 per 1000 newborn in comparison with 1992 when it was 18.1. In Russia last year the Perinatal mortality rate was 14.3 per 1000. Perinatal mortality in the nine counties which our Center takes care of was 9.9 per 1000. (This compares with a rate of 9.4 per thousand in Cuyahoga in 2000, the Cuyahoga mortality rate being slightly above the national rate, according to MetroHealth chief neonatologist, Dr. John Moore). All these statistics for 2000 are in spite of decreasing health levels of pregnant women and increasing high risk pregnancies. For example, we had 96.2% high risk pregnancy in our Perinatal center last year and we had 3000 labor and deliveries and 3033 newborns.18.9% of deliveries were finished by C.Section. The morbidity of the newborns which was a result of inborn anomalies decreased last year by 230 % and it showed the improved work of our antenatal diagnostics. Of course one of the reasons of this improvement was the visit of Dr.Ashmead to Volzhsky in 1999 and his lectures on fetal monitoring and preventive actions.

Our NICU uses extensively the Blood Gas Machine which we received from MetroHealth Center and then repaired with GCVOA’s help. This year we developed more than 1000 analyses of blood gases. The normal work of this machine is one of the main requirements of modern Perinatal Care about which Dr.Moore has spoken more than once. Our NICU had 820 patients last year on 21 beds. Mortality rate was 5%. 65.5% of these newborns were discharged home and 34.5% were moved to other hospitals for specialty care . The physicians from our transport team provided 1350 consultations by phone; in 239 cases our physicians went to other districts, including districts in the northwest and 119 transportations of newborns were made from other hospitals to our Center. In 51 of these cases the newborns were provided with Artificial Lung Ventilation.

In conclusion, I would like to say and not only from me but also from my Head Doctor Michael Kirichenko and from many other physicians of our Perinatal Center that our cooperation, our joint work around Perinatal Care in Volgograd Region is bearing fruit. We together have already achieved some good results and I hope that our continuing relations and cooperation will help us to achieve more.