Optimized Prenatal Routing Model: Clinical and Organizational Efficiency. The Experience of the Samarkand Region, Republic of Uzbekistan
Year: 2026
Type: article
Abstract: Aim. To evaluate the clinical and organizational efficiency of an optimized model for routing pregnant women from 28 weeks of gestation to a planned delivery facility using the Digital Medical Evaluation and Diagnosis (DMED) system. Design. Prospective comparative study. Materials and methods. The study included 624 patients at 28 weeks of gestation. The study group (n = 322) consisted of pregnant women monitored by maternity hospital obstetricians from 28 weeks of gestation using the DMED system and stratified into three complication risk categories. The control group (n = 302) included women who received standard outpatient care. The course of pregnancy, delivery outcomes and the incidence of perinatal complications were analysed. Results. Implementation of the optimized routing model led to a significant reduction in the emergency hospitalization rate in the study group, where it stood at 59 (18.3%) versus 105 (34.8%) in the control group (p < 0.05). In addition, the incidence of preterm labor in the study group was 1.6 times lower than in the control group (50 (15.5%) vs. 76 (25.2%), respectively), while the perinatal mortality rate was more than twofold lower (4 (1.2%) vs. 8 (2.6%) of cases). In the study group, scheduled operative deliveries prevailed (n = 61; 18.9%) over emergency ones (n = 31; 9.6%), whereas in the control group, emergency deliveries occurred almost twice as frequently, accounting for 66 (21.9%) vs. 37 (12.3%) for scheduled ones. Conclusion. The proposed routing model can enhance the quality and safety of obstetric care by eliminating its fragmentation, strengthening continuity across service units and improving perinatal outcomes. Keywords: prenatal women routing, Digital Medical Evaluation and Diagnosis system, obstetric care optimization, perinatal outcomes, emergency hospitalizations, risk stratification
Source: Doctor Ru
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7204199646