УДК: 618.39:618.179(477+477.83)"2014-2021"

Aim. The research aims at rationalizing of the epidemiological component in the process of developing a model for preventing miscarriage among the female population of Ukraine.

Materials and Methods. A retrospective analysis of the indicators of miscarriage among the female population of Ukraine and Lviv region for the period from 2014 to 2021 was carried out. Statistical data of the Center for Medical Statistics of the Ministry of Health of Ukraine were used, namely Form No. 21 "Report on medical care for pregnant women, women in labor and women giving birth". The study uses the methods of a systemic approach and structural-logical analysis, medical-statistical analysis, namely the calculation of chain (relative to the previous year) indicators of a dynamic series: absolute growth, growth rate and increment rate.

Results and Discussion. A decrease in the female population of fertile age by 13.03% in Ukraine and by 5.81% in Lviv region was noted in the analyzed period of 2014-2021, while the number of spontaneous abortions in Ukraine decreased by an average of 3.45% per year, and grew in Lviv region in 2015, 2018, 2019 and 2020 by 5.72%, 6.87%, 19.29% and 6.59%, respectively. The rates of spontaneous abortions per 1,000 women of fertile age in Lviv region were twice as low as in Ukraine. Over the analyzed 8-year period, the share of premature children among all live births increased from 4.68% to 5.68% in Ukraine, and from 4.18% to 5.65% in Lviv region, respectively; these indicators in Lviv region were smaller compared to the indicators in Ukraine. The share of premature babies among stillbirths averaged 63.07% in Ukraine and 67.69% in Lviv region, had a growing trend, and the indicators in Lviv region were higher every year compared to the indicators in Ukraine. The ratio of the total rate of miscarriage to the total number of pregnancies (cases of miscarriage per 100 pregnancies) increased from 5.50 in 2014 to 6.22 in 2021 in Ukraine and from 3.57 to 4.72 in Lviv region respectively.

Conclusions. There was a trend of annual increase in the index of the ratio of the total miscarriage rate to the total number of pregnancies, the share of prematures from the total number of live births and the share of premature births from the number of stillbirths in the analyzed 8-year period, both in Ukraine and in Lviv region. The analyzed indicators of the share of premature newborns from the total number of live births in Lviv region were lower every year, and the share of newborns from the total number of stillbirths was higher compared to the average annual indicators in Ukraine. The dynamics of spontaneous abortions showed a clear trend towards an annual decrease in Ukraine and their increase in 2015, 2018-2020 in Lviv region. The rate of spontaneous abortions among women of fertile age in Lviv region from 2014 to 2021 was annually half as low compared to the average annual levels of this indicator in Ukraine.

УДК: 614.2:616-073.7:303.4

The aim of this work was to assess the current state of the X-ray diagnostic service in the Lviv region, namely, to identify existing problems and elaboration of ways to solve them.

Material and Methods. A retrospective analysis of the current state of the X-ray diagnostic service in the Lviv region was carried out in comparison with the data throughout Ukraine for 2015-2020 years. The information was received according to the data of the State Statistics Service of Ukraine.

Results and Discussion. Analysis of changes in the total number of X-ray diagnostic apparatuses in the Lviv region for 2015-2020 years showed a slight downward trend in their number. Thus, as of the end of 2020 year, the total number of such apparatuses on the balance of regional health care institutions was equal to 452 units, which is 7,38% less than in 2015year. In the Lviv region and in Ukraine as a whole, there was a decrease in the number of devices of X-ray image amplifiers (X-ray IA) ((by -10,96% and -5,28%) and fluorographs (by -23,08% and - 17,49% respectively). At the same time, there was a significant increase of angiographic apparatuses (by +66,67% and +81,54%), CT scanners (by+40,00% and +26,32%), and mammography machines (by +33,33% and +12,46% respectively). The number of carried-out diagnostic fluorograms for 1 operating apparatus in the Lviv region during the studied period was decreasing, and the same trend persisted in 2020 year as well: Тgrowth2018/2015=-5,07%, Тgrowth2020/2019=-7,64%, just like the quantity of diagnostic fluorograms for one position of a radiologist: Тgrowth2018/2015=-11,76%, Тgrowth2020/2019=-20,78%. While the number of CT per one operating device and on one position of a radiologist in the Lviv region for the last 5 years significantly increased and in 2020 year was equal to 10605 studies /1 device and 220 studies/1 physician, but only in the last year, the growth was by +29,16% and +41,03%, although the number of operating tomographs remained unchanged for the last 5 years (n=5). Such a significant positive trend is explained by intensive work of the X-ray diagnostic service during the Cоvid-19 pandemic.

Conclusions. The decreased frequency of the fluorographic and radiological studies and the increase of the number of diagnostic CT scanners in the Lviv region have been determined. A number of problems in the work of the X-ray diagnostic service have been identified, the most important of which are the significant overload of radiologists, particularly, during the Cоvid-19 pandemic and lack of modern equipment. Modern healthcare is competitive and therefore, in the conditions of today's needs, the development of the most modern visualization technologies is very important, the key of which are computed tomography and magnetic resonance imaging in the field of radiation diagnostics.

It is observed a correlation between the administration of artificial ventilation in the neonatal period and the subsequent formation of bronchopulmonary pathology.
Aim: To study the frequency and the features of the course of broncho-pulmonary pathology in young children who were on artificial ventilation of the lungs in the neonatal period.
Materials and methods: The directions of the selection of medical histories were conducted, which was carried out by artificial ventilation of the lungs for pulmonary causes. The article presents the literature data and own experience of authors, which proves that there is a correlation between the conducted artificial ventilation of the lungs in the neonatal period and the subsequent formation of bronchopulmonary pathology.
Results: The results of a retrospective analysis of 475 children who received respiratory therapy are shown. It is a positive correlation is observed between the duration of artificial ventilation and the incidence of bronchitis (p <0.005) and pneumonia (p <0.005). There is a close correlation between the early introduction of artificial feeding and the development of allergies. We found a positive correlation between the presence of allergic pathology and hereditary predisposition to the development of atopy, gestational age and the development of bronchopulmonary dysplasia.
Conclusions: In 27% of children who stayed on artificial ventilation during the neonatal period, there was a recurrent broncho-obstructive syndrome in early childhood. Premature children who have undergone acute pulmonary disorder and hereditary hereditary burdens should be considered as a highrisk group for developing bronchial asthma. Repeated episodes of broncho-obstructive syndrome in young children, who during the neonatal period were on artificial ventilation of the lungs, were most often due to bronchial asthma, which was characterized by a severe course 

УДК 616-036.22:618.39]-037(477+477.83)

Мета. Обґрунтування прогностичної складової в процесі опрацювання моделі попередження невиношування вагітності серед жіночого населення України.
Матеріали і методи. Проведено ретроспективний епідеміологічний аналіз динаміки невиношування вагітності серед жіночого населення України та Львівської області за період з 2014по 2021 роки та здійснено прогнозування показників даної патології до 2026 року. У роботі застосовано методи системного підходу та структурно- логічного аналізу, медико- статистичного аналізу та прогнозування за допомогою експоненціального згладжування за двохпараметричним методом Холта.

Результати й обговорення. За аналізований період з 2014 по 2021 роки відмічено зростання індексу співвідношення загального показника кількості невиношування до загального числа вагітностей (випадків невиношування на 100 вагітностей) з 5,50 у 2014 році до 6,22 у 2021 році в Україні та відповідно з 3,57 до 4,72 у Львівській області. З метою прогнозування нами було обрано метод експоненціального згладжування за двохпараметричним методом Холта (Holt). На нашу думку даний показник співвідношення найменше буде залежати від впливу війни та пандемії COVID-19.
За інших незмінних умов, результати прогнозування передбачають, що у 2026 році в Україні показник співвідношення невиношування до загального числа вагітностей становитиме 6,37 випадків невиношування на 100 вагітностей, а у Львівській області 5,38 випадків невиношування на 100 вагітностей.
Висновки. Аналіз показників динаміки співвідношення невиношування до загального числа вагітностей за аналізований 8-річний період як в Україні так і у Львівській області показав тенденцію до щорічного зростання даного індексу.
Погіршення демографічної ситуації за результатами дослідження, а також ймовірний розвиток демографічної кризи у зв’язку з воєнним станом в Україні та спровокованою ним масовою міграцією жіночого населення, вимагає пошуку усіх можливих шляхів, щодо попередження невиношування та врахування цієї прогностично- негативної тенденції у розробці профілактичних програм.