Childbirth with a "crown", an 11-year-old mother and a smoke break at the cost of life. A well-known doctor from Vitebsk about work and personal

Lyudmila Roslik Deputy chief physician for the medical part of the Vitebsk Regional Clinical Maternity Hospital

The miracle of the birth of a new life is the magic and eternal mystery of the Universe. The maternity hospital is a round-the-clock combat post. Doctors in maternity hospitals are like magicians, helping to keep the breath of new life in the womb and the first to touch the helpless little ball, loudly announcing its arrival on Earth. But, unfortunately, not all newborns have the strength to scream ... Few people know what sometimes colossal efforts, extreme concentration are for teams of obstetricians and gynecologists. As well as about how much the small miraculous ampoules of life cost for the state, thanks to which some newborns receive the right to life.

They are in medical readiness round the clock, without days off and holidays. Obstetricians, gynecologists, anesthesiologists, resuscitators and, of course, the leadership of the Vitebsk Regional Clinical Maternity Hospital.

The creative cycle of materials from the author's project "The fate of women - the fate of a united Belarus" by member of the board of the Belarusian Union of Women, journalist Alina Grishkevich, which is published in the Year of National Unity, the 80th anniversary of the start of the Great Patriotic War and the 30th anniversary of the BUZh, continues with a story about a physician, about whom They say the DOCTOR is from God. This is a member of the Belarusian Union of Women, Deputy Chief Medical Officer of the Vitebsk Regional Clinical Maternity Hospital (having a 100-year tradition) Lyudmila Adamovna Roslik. Only pregnant women diagnosed with covid are now admitted to this maternity hospital, the first child in Belarus from a mother with covid-19 was born in it- He was born absolutely healthy. Since the beginning of the epidemic, there has not been a single case of infection in newborns. By the way, the first Belarusian in 2021 was also born here.

Newborns from 780 grams to 5.3 kg

Thousands of newborns passed through her hands. If they were all gathered together, then there would not be enough space for them in any assembly hall.

Largely thanks to the colossal experience, the highest professionalism of Lyudmila Adamovna and her colleagues, new lives are born in very difficult cases. During her professional practice, she has seen newborn babies weighing 780 grams and heroes over 5 kilograms.

The smallest baby in Lyudmila Adamovna's practice was born back in the pre-Covid period. The preterm birth happened at about 27-28 weeks. The situation was emergency - the woman was admitted to the hospital when the amniotic fluid had already broken. Artificial ventilation of the lungs, an incubator, a special drug - as a result, a 780-gram crumb, which literally fit in the palms, came out. Then they continued to monitor him already in the children's hospital.

As for the "large" newborns, then, according to experts, a large fetus develops mainly against the background of a high level of SUGAR in the mother's blood, including against the background of diabetes. And almost always, such a pregnancy ends in a caesarean section. After birth, such newborns are under special supervision.

The largest baby in Lyudmila Adamovna's practice was 5.3 kg.

In such cases, an instant adoption of the only right decision is required, on which the life of the mother and baby depends. Doctors fight selflessly for their life and HEALTH. And, of course, these are large financial government investments, because you have to take into account expensive drugs, and their price is sometimes in the thousands of dollars, modern equipment for maternity hospitals. But these are the resources for which the state does not spare money, because we are talking about the future generation, the future of the nation, and hence the state.

triplets

In the practice of Lyudmila Adamovna there were triplets. Such childbirth is always a caesarean section. Two boys and a girl from such a family have already grown up, study well, and make their parents happy.

However, there are very difficult life situations. So, one day, the father of triplets, instead of rejoicing at such a replenishment, decided that out of the three born, only one child was his ... A student mother, whose pregnancy was unplanned, found herself in an extremely delicate situation. Not only did they fail in studies (they eventually managed to pass thanks, among other things, to the help of doctors who also helped arrange academic leave), but also without the support of dad. But this story has a happy ending. Several years passed, and one day a woman turned to Lyudmila Adamovna in the ward: "Don't you remember me? I gave birth to you." She not only graduated from high school, but also received a second education, got married. The fourth child was born in a happy family.

A little from the production biography

Lyudmila Adamovna is an obstetrician-gynecologist of the highest qualification category with 35 years of experience. In 1986 she graduated from the Vitebsk State Order of Friendship of Peoples Medical University. She worked for three years in the Liozno Central District Hospital, and since 1989 in the Vitebsk Regional Clinical Maternity Hospital. For many years of fruitful work, high professionalism and great personal contribution to the provision of medical care to the population, she was awarded the badge "Excellent Health Worker of the Republic of Belarus", in 2020 she was awarded the title "Person of the Year of Vitebsk Region".

In 2019, she mastered and implemented surgical interventions of a high degree of complexity, performed over two hundred complex and high-tech reconstructive gynecological operations, which allowed her to maintain reproductive function, improve the quality of life and the working capacity of women.

Lyudmila Adamovna does a lot of work to improve reproductive health, protect motherhood and childhood, reduce the incidence of pregnant women and newborns. Largely due to this, the achievement of the main quality indicators in the maternity hospital was achieved: the survival rate of newborns with extremely low and very low birth weight is 100%, and there are no cases of early neonatal mortality. In addition, the proportion of preterm births has decreased, and there are no cases of maternal and postoperative mortality. The coverage of pre-abortion counseling was 100%, and the effectiveness of pre-abortion counseling led to a significant reduction in the number of abortions.

The courage of this outwardly soft and calm woman in making clear and almost lightning-fast decisions is striking, when the life of two, mother and baby, is on the scales.

The responsibility of the physician is always important. But this quality turned out to be especially important during that most difficult period when COVID-19 hit the world, confusing all plans and layouts, endangering the health and lives of many expectant mothers and newborns.

The moment when it became clear that covid, like a bolt from the blue, hit the entire global healthcare system, doctors will remember for a lifetime. Now their work is clearly divided into "before covid" and "during". How I would like to hope that soon there will be "after him" ...

medical dynasty

Lyudmila Adamovna - from a family of doctors. She was born in Leningrad, where her parents studied, both Belarusians. Mogilev's father studied at a military university, Borisov's mother - at a medical one. It so happened that Lyudmila followed in the footsteps of her mother, who worked as a pediatrician for many years, was the chief medical officer at the regional children's hospital in Vitebsk. The older brother was an anesthesiologist-resuscitator, worked at a research institute in Moscow, but, unfortunately, he passed away very early.

As Lyudmila Adamovna says, her mother's profession greatly influenced her choice of future profession. “When you grow up in a family where there are doctors, and at home you constantly hear medical terms, topics, discussions, this involuntarily begins to live in you too, you are imbued with it,” the woman says. “And I very clearly absorbed my mother’s respect from the very beginning and love for people. She constantly said that people should be loved and respected, help them." Therefore, the choice of a university after school was taken for granted - the Vitebsk State Order of Friendship of Peoples Medical University.

The study was interesting and flew by like an instant in the company of the same young people who are passionate about medicine. She met her other half while working in Liozno, where she was sent by distribution after the university, where she gained her first work experience. It was 1987-1989.

She traveled to a town 40 kilometers from Vitebsk on a working bus, which drove builders, and at the same time picked up a company of young doctors. In the same bus, a dentist from Vitebsk, as young as she, went to work in the same Liozno central regional hospital.

Slender, fair-haired and blue-eyed Lyudmila, perhaps, immediately liked the young dentist. She was not tall, was athletic and fast, and it was not in vain that she was engaged in orienteering and skiing. And he is a tall and stately guy, almost two meters tall. Almost like in that song: "Young is high - and I am small, young is charnyavy - and I was."

At that time they were only 24 years old - full of hopes and dreams, in love with work, cheerful and perky. They were interested together, as they say - on the same wavelength ... However, three years passed before they decided that they would link their fate with each other. The decision was weighed for a long time, but the choice turned out to be happy for both - they go through life together.

After the wedding, they first lived with Lyudmila's parents, then rented an apartment and built cooperative housing. She still remembers that quivering and wonderful moment when she realized that she herself would become a mother. Lyudmila Adamovna was then 31 years old.

Memories of this time are mostly joyful. However, as they say, there were costs of the profession - she, a pregnant woman, had to have abortions for women. Such is the work. Unfortunately, at that moment, none of the senior colleagues suggested - do not do this. Then the number of abortions was large, and at that moment the expectant mother worked under far from rosy impressions ...

Since then, she no longer works on abortions. Although, if there are difficult cases and her consultation is needed, then she goes to the operating room. The chief medical officer's attitude to abortion is the most negative, except in exceptional cases when it is necessary for serious medical reasons. According to statistics, every fourth woman who is going to terminate a pregnancy in family planning offices in Vitebsk antenatal clinics, after talking with doctors, leaves with the desire to save the child. Representatives of the charitable Catholic society Caritas, who worked closely with doctors before the covid situation, also help doctors in this.

... The whole family of Lyudmila Adamovna - her husband and daughter - are doctors. By the way, my husband's brother and his children also work in the medical field in MINSK.

Daughter Kristina, like her father (who works as an orthopedic dentist, HEAD of the department), chose a dental specialization and, after Minsk State Medical University, works as a dentist-therapist in a capital clinic. And on weekends, she comes to Vitebsk with pleasure, which her parents are incredibly happy about.

For a mother, of course, it is a great joy that her daughter followed in the footsteps of her parents and became a doctor, by the way, already in the third generation.

Lyudmila herself, in addition to her family and work, is very fond of the dacha, the bathhouse, nature, where she completely relaxes and, as it were, sheds off the burden of daily worries. Together with her husband, and sometimes with friends, whom she has had many since school days, they often go to the forest, where she loves to wander, pick mushrooms and just enjoy the beauty and charm of nature at any time of the year.

They also do their best to help the husband's elderly parents who live in Stolbtsy.

... For 16 years, Lyudmila Adamovna took care of her mother, who did not get out of bed after suffering a stroke. Caring for a bedridden mother at home did not cancel work that required round-the-clock feedback, and therefore a mobile phone was always nearby, did not cancel care for her daughter, who then just had to go to school, as well as routine home cleaning and cooking.

As Lyudmila Adamovna's colleagues say, not once in all that time did she complain that it was difficult for her ... But everyone who went through moral and physical tests, when a loved one is at home, understands that in such cases it sometimes happens simply unbearable ... She adequately passed the test in every sense of the word.

Births of mothers with a "crown"

Any conversation about medicine and health right now is, of course, related to COVID-19. Moreover, since the beginning of the epidemic, the Vitebsk Regional Maternity Hospital has been redesigned to work with covid-infected pregnant women who come here from all over the region.

“Coronavirus appeared a long time ago and, in general, this infection was known earlier, appropriate regulatory treatment protocols were created for it,” says Lyudmila Adamovna. “Of course, COVID-19 is a new type of CORONAVIRUS infection. However, we simply didn’t have time for long reflections. The patient with his diagnosis, his well-being, his emotions is here and now, and his treatment cannot be shelved. And even more so, our special patient is expectant mothers, newborns. "

Vitebsk, and in general Belarusian obstetrician-gynecologists themselves very quickly got their bearings and developed rules, some of which differed from the recommendations of the World Health Organization.

No newborn infections

The first child, who was born in Belarus from a mother with COVID-19, was born in this maternity hospital. He was absolutely healthy, which was a confirmation of the correct choice of pregnancy management tactics in the new epidemiological conditions.

“We came to the conclusion that a mother who is sick with coronavirus can infect a newborn through breast MILK . And, no matter how sad it may be for mothers, we immediately began to place babies in incubators. The children are there for a certain time under the supervision of doctors,” says Lyudmila Adamovna.

By the way, this principle was contrary to the recommendations of the World Health Organization, according to which newborns should not be taken away from their mother immediately after birth. But, as world practice later showed, this method did not allow to avoid cases of infection of infants with coronavirus. The WHO recommendations subsequently changed to the tactics that the Vitebsk obstetricians-gynecologists initially chose - another argument in favor of their high professionalism and colossal experience.

The result - not a single case of infection of newborns in the Vitebsk Regional Clinical Maternity Hospital. According to the doctors themselves, this was largely due to the decision taken literally in the first days of the epidemic to separate the mother and the newborn, as well as some other operational measures.

Team discipline

“During this difficult period, the team showed itself as a single whole,” Lyudmila Adamovna says proudly. “Of course, we have very strict compliance with all the rules and regulations. Work in special suits. Red zones and clean zones. in a new way. It's good that we were initially in sufficient quantities, fully supplied with overalls, respirators, shields, that is, with all the necessary protective equipment. We were helped by the Vitebsk Regional Health Department, enterprises of the city and the region, especially entrepreneurs. And, of course, separate words of gratitude to our chief physician Elena Gennadievna Leonovich for the properly organized work."

Since the infection proceeds in waves, it would seem that it is possible to relax at some stage. But no, Vitebsk obstetricians and gynecologists are not going to do this. They are on a permanent medical post.

The most important indicator of the professional work of a well-coordinated team is when there are slightly complicated births, when babies are not in intensive care, because they are born healthy. And this requires relentless work so as not to miss even the smallest symptom of a possible disease. Competent monitoring of a pregnant woman in covid conditions is an extremely difficult process. Properly organizing medical care in such extreme situations is always an individual matter that requires the highest professionalism. And although the medical staff is ready for different situations, there is enough tension, so here they support each other in every possible way, clearly working as a team.

About very premature babies

Premature babies are a separate topic of conversation. Lyudmila Adamovna says that a significant proportion of premature babies are mothers with coronavirus infection. Moreover, this does not depend on the age of the woman in labor. Preterm labor can begin in both young and older mothers. It all depends on the severity of the coronavirus disease.

There was a case when a woman in labor with severe pneumonia was urgently admitted from the region to the regional maternity hospital for a period of about 28 weeks. Timely examination of the woman made it possible to take the necessary measures and save the baby.

Deeply premature newborns, whose lungs are not able to work themselves, are saved with the help of a special expensive medicine, which is administered to babies through the trachea within literally the first 5-10 minutes of life. These drugs are purchased by the state, which is a worldwide practice. The newborns are then placed on a ventilator for some time.

Of course, this is a stressful situation for women in labor, they worry, cry, and they cannot do without the support of psychologists. But how much joy and happiness later, when all this is behind and happy mothers with babies are discharged home.

In any situation, maternity hospital workers do their best to support women in labor, understanding their condition. By the way, many mothers, remembering the good attitude of doctors, strive to get back to the same maternity hospital - for the second and third time, and some even more often.

Three cigarettes for a lifetime

Obstetricians have to deal with cases when expectant mothers lead an asocial lifestyle, smoke and drink, and then give birth to children with various kinds of pathologies. And this is a real tragedy for society.

Of course, smoking is not allowed in the rooms. And even more so for pregnant women. As if everything is clear. But not everyone. It used to happen that a doctor came to pregnant women, and it was smoky there ...

Smoke detectors are now installed in the wards, which are connected to the central console, which clearly respond to cigarette smoke. There was a case when the expectant mother decided to smoke in the ward and was very surprised by the arrival of the relevant services and the fine issued to her. That example was instructive.

Lyudmila Adamovna tells about a tragic case when a mother's smoking killed a healthy, full-term baby. The doctor was on duty that day. Then there was no covid yet, and pregnant women went out into the street, walked around the territory of the maternity hospital. Hiding behind one of the buildings, a group of women were smoking. On the round, when examining one of the smokers, the doctor did not hear the heartbeat of her baby, who was due to be born soon - the period was 35-36 weeks. That woman smoked three cigarettes in half an hour. Just like that, for the company. Three cigarettes for a lifetime...

Moon lying on stomach

Все будущие мамы очень разные. В основном - ответственные, волнующиеся за будущих малышей и четко выполняющие предписания и рекомендации врачей. Настоящее восхищение у медиков вызывают те, кто делает казалось бы невозможное, чтобы у них появился ребенок, здоровый и желанный.

So, Lyudmila Adamovna spoke about an athlete-swimmer, whose second pregnancy fell on the covid period. She was admitted to the maternity hospital with bilateral pneumonia, in serious condition. It was good physical preparation that helped fight for the health and life of the unborn baby. She managed to do without artificial ventilation of the lungs - she saved a large volume of lungs, which is typical for those who go in for swimming. For more than a month she lay in the maternity hospital practically on her stomach, which turned out to be saving in her situation. The woman showed real courage, enduring everything for the sake of her child.

Not so long ago, a 40-year-old woman in labor was urgently brought from one of the regional centers. Against the background of the coronavirus, she had a threat of fetal death, but thanks to the coordinated actions of doctors, the birth went well. It is impossible to describe in words the happiness of women who give birth safely in seemingly the most difficult situations.

The youngest mother was 11 years old

However, there are also extraordinary situations, such as childbirth at 11 years old. This case is from the early practice of Lyudmila Adamovna. The 11-year-old girl, in fact a child, was scared to death and did not really understand her condition. There was parental consent to hospitalization and delivery. They did a caesarean section. How then the fate of such a young mother developed is unknown.

“I think if the family pays enough attention to the child, talks to him about sex education, this should not happen,” the doctor reflects. “Thank God, there were no more such cases in my practice.”

The oldest in practice is a 50-year-old woman in labor

The woman married late, and therefore the pregnancy was late, but very desirable - at the age of 50.

Lyudmila Adamovna believes that everything should happen as timely as possible, at a young age, when the mother is full of strength and health. Although now the world has changed, and women in labor are getting older, which does not please doctors at all, since when conceived after 36 years in women and over 45 in men, the risk of genetic defects of the child increases. But, as they say, everything is relative.

“No one will say what is right. It’s good when a girl is lucky to successfully marry a beloved and loving person who wants a family, a child,” the doctor says. “Everyone makes a decision for himself based on his situation. I don’t blame anyone. Probably in my youth, I would say that a child should be born in a complete family, where there is a mother and father. Now I would not say so. After all, there are plenty of cases when women are smart, beautiful, wealthy, but did not meet their fate, did not get married. unfortunately… I think that if a woman wants to realize her maternal feelings without having a husband, then this is quite normal.”

“I am a conservative, and I think that a woman should realize herself as a mother, wife, professional. But how it turns out, everyone chooses their own path and everyone has their own destiny,” says Lyudmila Adamovna.

Motherhood must be responsible

“Motherhood must be responsible,” says Lyudmila Adamovna, referring to a lot of factors. “Including the responsibility of the expectant mother for her own health long before pregnancy - a healthy lifestyle, healthy nutrition, planning for the unborn child. If a woman is preparing for pregnancy, then she should visit an obstetrician-gynecologist who will give recommendations on a healthy lifestyle and a balanced diet with enough proteins, fats and carbohydrates.Diets and vegetarianism, a sedentary lifestyle are not very suitable for the development of a full-fledged fetus.Everything must be balanced, extremes are fraught with negative consequences ".

Lyudmila Roslik said that a large weight of a woman can interfere with conception, and its decrease will contribute to pregnancy.

Contraindications for pregnancy are severe diseases. However, women do not always listen to the recommendations of doctors ...

There is another problem - termination of pregnancy. Unfortunately, at a young age, girls do not always realize what irreversible health consequences the termination of the first pregnancy and abortion in general can lead to, not to mention the moral aspects. Having done this once, a woman may subsequently forever lose the opportunity to become a mother.

About emotions at work

“This is a daily job. It’s good when everything goes smoothly. However, you experience enough stress, because each situation is always unique and always important, especially now when we work with covid patients,” the doctor shares. “We have a third-level institution, women in labor with severe pathology come from all areas. We must respond quickly."

A team of doctors works at each birth: an obstetrician-gynecologist, anesthesiologist, resuscitator. For example, a large child, multiple or too frequent pregnancies are a risk of bleeding. Obstetric bleeding is very massive, when in 10 minutes you can lose more than one liter of blood, so a whole team of doctors is on duty day and night ...

About miracles

Of course, miracles happen before the eyes of doctors. How else can you call those cases when, according to experts and for medical reasons, women have no chance of getting pregnant at all, and this happens in spite of everything. Not everything can be explained. "The desire for motherhood conquers all common sense," says Lyudmila Adamovna.

What do they say about her in the team

In the team, Lyudmila Adamovna is described as follows: "She is a person, a person of high moral culture, decent, intelligent, sympathetic and very honest. And this is very important when people work in a team who honestly talk about how they see the situation and how to do the right thing in the interests of the common cause. This is not the satisfaction of personal ambitions, but highly professional assistance to patients. She will not stand aside, she will go ahead. She is honest in everything. A real person and a doctor with a capital letter."

Such words are valuable.

head physician

The head physician Elena Gennadievna Leonovich is called not only a good doctor, but also an excellent business executive, which is a big compliment for a woman leader. She is a fan of the team and stands up for her employees. Everything that can be done for the maternity hospital is done according to the mind. When in 2016 all women's clinics of the city were attached to the regional maternity hospital, the head physician personally controlled the progress of construction and improvement, not letting the builders down (having provided all medical questions to her combat deputy). It is a matter of honor for her that everything is beautiful. The maternity hospital is framed by a well-groomed landscaped area with flower beds, flowers that delight with bright autumn colors.

Elena Gennadievna says about her deputy for medical affairs: “We have been working together for 16 years. There are more than one thousand women in whose lives she took part and made a verified decision. Proper and competent treatment helps to achieve a positive outcome. Obstetrician-gynecologists do not like the word “save "Our task is to treat. Pregnancy is a normal physiological state of a woman. In our current conditions, 90% of women have a complicated pregnancy, some are mild, some are moderate. And the right tactics for managing pregnancy allows you to successfully complete her".

About maternity hospital

The Vitebsk Regional Clinical Maternity Hospital was opened 13 years ago after reconstruction by the head of state ALEXANDER LUKASHENKO . In 2021, he again visited this medical facility. For the team, it was a kind of exam - to show and tell that public funds were not invested in vain.

The visit turned out to be positive in terms of the fact that the medical institution was replenished with new modern equipment necessary for the maternity hospital. In particular, this is an expert-class ultrasound machine that allows you to monitor the intrauterine development and condition of the newborn. And most importantly, it allows diagnosing malformations in newborns at an early stage and promptly raises the question of correcting these malformations at the stage of delivery.

The new laparoscopic stand for minimally invasive surgical gynecological operations for a variety of diseases turned out to be very useful.

The process of updating equipment is continuous. As they say in the maternity hospital, at the end of last year, a high-quality anesthesia machine for the intensive care unit was received. Thanks to international financial resources, equipment for newborns has been updated in the children's department - new incubators and ventilators have been purchased.

Now there is also a novelty in the maternity hospital - a modern monitoring station for incubators. It allows the doctor, being, for example, in the doctor's office, remotely monitor all newborns in real time from the central monitoring console, receive alarm notifications, and view the saved data.

"Medicine cannot live in the past. To keep up with the times, to provide medical care at the modern level, it is necessary to change the fleet of equipment in a timely manner," the management of the maternity hospital believes.

Some statistics

Obstetrics is two lives at once. Maternal and child mortality rates are among the leading indicators of the standard of living, as well as the quality of the health care system. In Belarus in 2020, these figures reached a historic low. The infant mortality rate in the country corresponds to the average level of the EU countries. In terms of infant mortality, Belarus is ahead of all CIS countries and many developed countries of the world, including Great Britain, Denmark, Lithuania, Poland, and the usa . The survival rate of children with extremely low body weight in the first year of life is more than 80%. The primary disability among this category of children does not exceed 17-18%.

Belarus became the first country in Europe and the third in the world (along with Cuba and Thailand) where it was possible to reduce the transmission of HIV from mother to child and congenital syphilis to a level that does not pose a threat to public health. For more than 20 years, a multi-level system of maternal and child health care has been successfully functioning in the country. The legislatively fixed priority of providing medical care to mothers and children and a well-organized system of assistance, measures taken at the state level for social support of motherhood and families with children made it possible to achieve this.

The most beautiful newborns

"We have the most beautiful newborns in the world," they say in the Vitebsk Regional Clinical Maternity Hospital.

"Vitebsk is the city in which I was born," against the background of these words, the babies being discharged from the maternity hospital are photographed. A beautifully decorated room almost at the very exit from the maternity hospital is a place where fragile precious bundles with newborn boys and girls are carefully transferred into the hands of relatives and friends, newly-made daddies. These are always very touching and touching scenes of happiness inexpressible in words. Not only for relatives.

But also for doctors. This is the meaning of their whole life. They are not politicians, they are doctors. But it so happened that they evaluate the value of the state by what this state does for the good of a person, how much money it allocates to ensure that there is a healthy motherhood and childhood, that there is modern equipment for diagnosis and treatment, that there are those precious ampoules of life , which give the right to the first cry to a premature baby in the womb. A lot is being done for this in Belarus. That's all politics.

Alina GRISHKEVICH,

BELTA.