Chief obstetrician-gynecologist. Chief gynecologist. What does a gynecologist treat?

“I held the patient’s hand for two days”

Rules of life for the country's chief obstetrician-gynecologist

Anastasia Gnedinskaya

The working day of the chief obstetrician-gynecologist of Russia, Leila Adamyan, begins at seven in the morning. In the elevator, she takes off her watch and rings and puts on surgical pajamas as she goes. In ten minutes - surgery. There are few such titled women in Russian medicine. Leyla Adamyan is an academician, Honored Scientist, holder of the Order of Merit for the Fatherland, IV, III and II degrees. But every day, like forty years ago, she performs several complex operations.

January twentieth is Leila Vladimirovna’s anniversary. A RIA Novosti correspondent spent one day with this amazing woman.

"Responsibility for Two Lives"

Leila Adamyan schedules the interview for nine in the morning. By this time she has been on her feet for four hours. To keep up with everything, he gets up at five. “I sleep four to five hours, no more. I can't afford to waste my precious time. But I don’t have problems sleeping, as soon as my head touches the pillow, I pass out,” while we walk along the corridors of the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Leila Vladimirovna talks on abstract topics. There are several tense hours ahead - she was urgently called to see a woman with a severe form of uterine fibroids.

The surgeon exchanges high-heeled shoes for clogs with high wedges only at the entrance to the operating room. She believes that even in the most difficult work a woman should remain elegant. He will come out only after an hour and a half. She will put on a white coat and fly back to the waiting room, where patients are already waiting for her...

Unlike most famous doctors, Leyla Adamyan was born into a family not related to medicine. His father is a master engineer at a factory, his mother is a primary school teacher.

Raising two girls, they could not imagine that both would later put on white coats. The neighbors chose the profession for the sisters. More precisely, not even the neighbors - the yard. In Tbilisi, the family lived in a house united by a typical courtyard-well. In total, there were 17 “social cells” huddled there, and in each there was a huge number of grandmothers, grandfathers, and aunties. It is not surprising that the ambulance visited them with alarming regularity.

“I always ran out to meet doctors. While they listened to the patient, gave him injections, she stood nearby and observed,” Leila Vladimirovna recalls during an interview with RIA Novosti. “For me, people in white coats were real angels who came to a sick person and left a healthy one. Over time, the doctors got so used to me that they asked me to write something down on the card, count my pulse, and help me bandage the wound. And I did it with great pleasure.”

By the age of eleven, Leila clearly knew which symptoms required a magnesium injection and which ones needed mustard plasters.

It so happened that from the third grade she and her sister were raised only by their mother. “We clearly agreed with her: she works, I study. And I tried really hard. Suffice it to say that at school I was the only medalist for four graduating classes,” notes the obstetrician-gynecologist.

Leyla Adamyan’s second hobby was sports: despite her short stature, she was the captain of the youth women’s volleyball team.

“Even then, I got used to teamwork, to the fact that the success of the game largely depends on my decisions and on cohesion in the team. I took responsibility and got drive from it. This was one of the decisive factors when choosing a profession. I needed a job where I would not be on the sidelines, where a person’s fate would depend on me. Obstetrics is such a fateful specialty. Moreover, here the risk is multiplied in half, because you take responsibility for two lives at once - a woman and an unborn baby. Or, which is also very significant, you give the opportunity to experience the feeling of motherhood for those who were deprived of this due to various diseases.”

Leila Adamyan was accepted into the medical school based on the results of a single exam - as a medalist. And it didn't last long.

“I remember that I didn’t even want to leave the office, I kept waiting for them to ask me more questions. The voiced ones seemed too easy,” recalls the agency’s interlocutor.

Leila Adamyan came to work at the Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov 47 years ago

She initially did not want to be a gynecologist - she saw herself as a surgeon. But my husband was categorically against it. “At that time he was already working as a surgeon at the Vishnevsky Institute. But two operating doctors in a family is too much,” explains Leila Vladimirovna. “I obeyed and went to the gynecology department.” And then, as it happened, I chose surgery anyway.”

“I didn’t leave the patient’s side for two days”

Leila Adamyan came to the Center for Obstetrics, Gynecology and Perinatology named after Academician V. I. Kulakov 47 years ago - in 1971. At first I was a subordinate, then a resident. In the mornings, together with the nurses, I personally took blood from all patients. Once a week I assigned myself duty in the birthing room. “I took on everything. I believe that a real doctor, and especially an obstetrician-gynecologist, should be able to deliver a child and stop the bleeding.”

After night shifts, I hurried home to my two daughters, whom I gave birth to while studying at the 1st Moscow Medical Institute named after I.M. Sechenov. One - during the winter holidays, the second - during the summer holidays.

“By the way, we have a phenomenal family: my father, me and my daughter were born on January 20 at the same time,” the interlocutor cites an interesting fact.

Leila Adamyan will never forget one of her night shifts. She was urgently called to the operating room: a woman in labor named Marina was bleeding. As it turned out, the woman hid from the doctors that she had a serious illness in which the blood does not clot. “When I was called into the operating room, she had already lost two liters. Over the next two days - another 23. Just think about it: 25 liters of blood. An adult has only five of them. We transfused blood to her, but she lost it...” explains the doctor.

The donors for Marina were cadets from the police school located opposite the hospital - they lined up to donate blood for the dying young mother.

For two days Leila Vladimirovna did not leave the patient’s side: she held her hand. Even lunch was brought to her in the intensive care ward. “Something had to be done, because things couldn’t go on like this. And I called my husband. He then headed the department of dressings, sutures and polymer materials at the A.V. Vishnevsky Institute of Surgery, where they just began to carry out the first embolizations (that is, “blocking” arteries using a minimally invasive method. - Ed.). True, before this case, the technology was used mainly for cerebral hemorrhages or during brain surgery.

I remember how I begged into the phone: “I have a woman dying in my arms, do something, because she won’t survive another operation!” He asked if the patient was transportable. And we took responsibility for transportation upon ourselves.”

This was the first embolization in obstetrics and gynecology in the Soviet Union. The blood was stopped and Marina survived. “When we gave material about this operation to the Izvestia newspaper, the journalists even decided to correct the volume of blood loss: instead of 25.5 liters they wrote 2.55. No one could believe that a person could lose so much blood and remain alive,” Adamyan notes.

Article in Izvestia dedicated to the rescue of Marina

34 years have passed. Marina periodically calls Leila Vladimirovna. And recently she brought her son and said that she came for her grandchildren.

“I will pray for her”

For forty-six years in a row, Professor Adamyan has been hosting on Thursdays. But on other days there is a line in front of her office. In the corridor of the operative gynecology department, which she heads, a visitor in a colorful robe and scarf rushes towards Leila Vladimirovna. “Every day I will pray for you that you didn’t refuse,” she thanks the doctor in broken Russian.

She asks not to take pictures of her and not to mention her name. In the Tajik city of Khujand, where they came from, no one knows that her daughter has a rather rare gynecological problem - the girl was born with an undeveloped uterus and vagina. This pathology is called aplasia.

“If someone in our city hears about this, they won’t marry me. But she’s my fifth child, she’s beautiful,” the mother almost cries.

He explains that over the years he visited dozens of doctors in Tajikistan, but no one could help. “Everyone says that this is a congenital defect, it cannot be treated, you need to live like this. How so? She needs to get married..."

One of the doctors advised me to go to Moscow, to see Leila Adamyan. “I read the Internet and found everything about her. She is a doctor from God. She told me: “Don’t cry, I’ll do the operation myself, everything will be fine. Now my girl is already being prepared, in two hours Leila Vladimirovna will take her.”

In the office, the obstetrician-gynecologist clarifies that such a malformation of the female body is not at all unique. Diagnosed in three percent of girls. And it was Leila Vladimirovna who developed the original method for eliminating this defect. Moreover, at the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, more such operations were performed than in the whole world. “We create a vagina from the peritoneum and do everything so that the patient becomes a full-fledged woman,” explains the doctor.

Why are they planning to merge maternity hospitals and antenatal clinics, what examinations are offered to pregnant women free of charge, and at whose expense do visitors give birth in the capital?

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The chief freelance specialist in obstetrics and gynecology of the Department of Health spoke about this on Radio Komsomolskaya Pravda (97.2 FM).

WOMEN'S HEALTH CENTERS MAY APPEAR IN THE CITY

Alexander Georgievich, ordinary city clinics have long been combined with each other, and multidisciplinary hospitals with maternity hospitals. Now the next step is the merger of maternity hospitals with antenatal clinics. Why is this necessary?

We have undergone a major modernization of our entire healthcare system. We are talking not only about obstetrics and gynecology services, but also about all the changes in urban medicine over the past five years. One of the first fundamentally important steps in this direction was the merger of maternity hospitals with multidisciplinary hospitals. This has made it possible to significantly increase the efficiency of specialized, including emergency medical care for expectant mothers, reduce the number of complications during pregnancy and childbirth, and significantly reduce maternal mortality from the most common causes. That is, everything is done for patient safety and accurate diagnosis.

The connection of antenatal clinics to multidisciplinary hospitals should be completed in September this year. This will make it possible to create a completely self-sufficient integrated model of medical support for a woman, from the first visit, observation during pregnancy and childbirth - to the provision of high-tech assistance in the event of detection of certain gynecological diseases.

Expectant mothers can now receive treatment, monitor pregnancy and give birth in one institution. I would call them women's health centers. Because, although it is believed that pregnancy and childbirth are a physiological process, different situations may arise when urgent help is needed not only for an unborn or unborn child, but also for its mother. This way we can intervene quickly. Serious equipment such as computed tomography (CT), magnetic resonance imaging (MRI), sophisticated medical equipment - all this is available in a multidisciplinary hospital, which includes a maternity hospital with all departments, and an antenatal clinic. We will complete their unification by the end of autumn.

- What if the maternity hospital is far from the hospital?

Of course, this would be an ideal situation - a hospital and a maternity hospital on the same territory. But today in the city there are separate maternity hospitals and separate multidisciplinary hospitals. We tried to distribute them geographically so that patients and doctors did not have to walk far. For example, if necessary, specialists from the hospital can come to the maternity hospital or transport the patient to a multidisciplinary hospital to provide emergency care. All antenatal clinics remain at their own address, where residents are used to coming. Only doctors and obstetricians and gynecologists working in this antenatal clinic become employees of the nearest multidisciplinary hospital.

HUSBAND, “SLAVE” AND PHOTOGRAPHER WILL HELP WITH CONTRACTS

It turns out that soon all maternity hospitals in the city will become the same as the elite clinical hospital "Lapino" and the Perinatal Center on Sevastopolsky Avenue?

Now every institution that has a gynecological department and a maternity hospital is trying as much as possible to improve the comfort of patients’ stay.

By the way, about comfort. Some people need a husband in the maternity hospital, others need a vertical birth or in water. We also have a foreign feature - a doula (translated from Greek as a slave. This is an assistant during childbirth who provides a woman with practical and psychological support. For example, she gives a massage, brings water, calms her down. - Note). Some pregnant women even take photographers and videographers with them at the most crucial moment. How do doctors feel about this?

Need a doula in your maternity hospital? Yes please, we did it. Does the patient want her husband to be present at the birth? All our maternity hospitals are open so that not only the husband is present at the birth, but also the mother and sister. Of course, not the whole family, but someone alone. To do this, the husband or another relative needs to have a fluorography done so that we know that he has no changes in the lungs. Then the deputy chief physician of the maternity ward gives permission to attend.

- And some husbands play the guitar in the maternity room...

Still, let's not make the maternity ward into some kind of farce. We try to have the patient choose with whom she wants to share an important moment in her life, and this person will be present with her at the birth. It happens that this is a videographer too. But still, more often, video and photography are done when the child and mother are discharged from the maternity hospital.

- There are still supporters of home births...

I absolutely do not recommend home birth. This is the most dangerous thing if in such a situation the patient remains outside the medical facility. Someone gave birth at home and says that everything went well. But for some it will be completely different. Therefore, there is no need to risk your life and the life of your unborn child. We do everything to ensure that patients come to medical institutions. Nowadays, many people want not just childbirth, but so-called natural childbirth. For example, in the maternity hospitals at the 68th hospital, and in the Yudin hospital, special baths are installed. Patients often ask for vertical birth, when the woman does not lie down, but stands. For example, maternity hospital No. 4 has been conducting vertical births for ten years. Now this is available in many maternity hospitals in Moscow. By the way, an expectant mother can, regardless of what district of Moscow she lives in, choose any maternity hospital in the city that is convenient for her, free of charge under the compulsory medical insurance policy.

- And if there is no insurance policy, no registration, what should I do?

We accept all patients in our maternity hospitals. Obstetrics are considered emergency medical care. In Moscow there are all opportunities for childbirth for both Muscovites and visitors. Therefore, any patient will receive all the necessary services and assistance during childbirth. Absolutely free. Even if at the time of contractions the patient does not have a compulsory medical insurance policy. No one gives birth on our streets.

FREE SURVEYS AVAILABLE FOR EVERYONE

- What examinations are pregnant women required to do free of charge?

All necessary tests, prenatal screenings and medications are provided to our patients without any additional payments. All you need to do is register for pregnancy and you don’t have to pay a penny for anything.

- That is, there is no need to conclude a contract for childbirth for 100 - 200 thousand rubles?

It is not at all necessary to spend a lot of money on childbirth. A contract is usually concluded because the patient wants to see one doctor both during pregnancy and during childbirth. She has been communicating with him for a long time, she has already gotten used to it, the doctor has become a close and trusted person for her.

- The topic of refusing screenings is often discussed on the Internet on forums for expectant mothers...

Screening of the unborn child must be carried out in due time. Prenatal diagnosis can find out whether the baby has, for example, Down syndrome or an incurable heart defect. Then parents have the right to decide for themselves what to do next.

Of course, this is not something to talk about on forums. You need to come to your outpatient center and ask the professionals about your concerns. Obstetricians are not the enemy of patients. I am aware of everything that is happening on the forums. We have a special service monitoring them. One patient missed the screening and writes to others on the Internet that there is no need to go to the doctors, saying that everything is fine with me. We constantly encounter this in our work. Therefore, I ask future mothers - instead of discussing on the forum, come for a consultation with a doctor.

- Radio listener Vladimir asks: “Why was the 16th maternity hospital in the artists’ village in the north of the city closed?”

We have to close some maternity hospitals because they are old buildings from the 30s with wooden floors. Reconstruction will no longer help such buildings. Instead, in the area of the artists’ village, a maternity hospital at Hospital No. 36 was opened after reconstruction, with modern operating rooms and comfortable boxes for women in labor.

Of course, where possible, we do major repairs. In addition, two maternity hospitals will open in Moscow this summer. This year, after reconstruction, we will open the former 5th maternity hospital, and now it is a maternity hospital at city clinical hospital No. 40. Another new maternity hospital will appear on the territory of infectious diseases clinical hospital No. 2.

THERE ARE RUMORS THAT...

Due to IVF procedures, Muscovites have more twins and triplets

In vitro fertilization (IVF) was included in the list of services under the compulsory health insurance policy two years ago. Any patient diagnosed with infertility, in the absence of contraindications and without age restrictions, can make two IVF attempts free of charge within one year. To do this, you need to contact your antenatal clinic and sign up for the IVF registry. Then choose one of 30 city, federal or commercial clinics that carry out this procedure under compulsory medical insurance (more about this on the website of the Moscow Department of Health).

One of the reasons for multiple pregnancies in a certain percentage, of course, is IVF. The increase in the number of such patients is certainly related to this. According to the Moscow Bureau of Medical Statistics, in 2015 there were only 1,798 multiple births in the city. Of these, 1,776 are twins and 22 are triplets. And in 2016 these numbers increased. There were already 1875 multiple births. Of these, 1852 were twins and 23 triplets.

ASKING QUESTION

At whose expense do migrants give birth in Moscow maternity hospitals?

Question from readers of our site: “At whose expense do visitors give birth in the city? After all, some of them go to doctors without insurance or compulsory medical insurance policies.”

There are no more immigrants among women giving birth than there are Muscovites. Moscow region – is it newcomers? And we have a fairly high percentage of births of patients from the Moscow region. Five modern perinatal centers will open in the Moscow region in the near future. Of course, married couples who live in the Moscow region will no longer come to Moscow to give birth.

I repeat once again, we accept childbirth free of charge for everyone who comes to us with labor pains. This is emergency help. Next, the Compulsory Medical Insurance Fund carries out mutual settlements with the regions.

DOSSIER "KP"

Konoplyannikov Alexander Georgievich was born in Tbilisi in 1962.

Gynecologist

If you need an appointment with a gynecologist in Moscow, contact Family Doctor JSC. Paid gynecologists are accepted in all clinics of our Network. The examination is carried out in the most patient-friendly manner. Modern and effective diagnostic methods are used, including video colposcopy, computed tomography, hysterosalpingography, Ultrasound of the pelvic organs. Our own laboratory allows us to carry out all the necessary laboratory tests efficiently and quickly. Analysis results the patient can see in his personal account on our website. If necessary, surgical treatment is performed (surgery on the uterine appendages, removal of benign tumors, etc.). Operations are performed in the company’s high-tech divisions – the Hospital Center and the Surgical Hospital.

What does a gynecologist treat?

Gynecologist is a specialist in the field of women's reproductive health. The quality of life of every woman largely depends on the health of her genital area. The task of a gynecologist is to prevent the development of pathologies, treat emerging diseases, and restore reproductive function (in case of infertility).

Scheduled and preventive visits to the doctor

Planned and preventive observation by a gynecologist

Since many diseases of the female genital area are asymptomatic in the early stages, doctors make an appointment with a gynecologist without waiting for complaints to appear. By being seen by a good specialist, you can save yourself from many problems.

Brings its own difficulties puberty. During this period, a teenage girl may need to consult a pediatric gynecologist.

Entering into sexual activity brings new risks: the likelihood of sexually transmitted diseases increases; A frivolous attitude towards contraception poses a significant threat to health.

At planning pregnancy It is highly advisable to undergo a high-quality examination and eliminate possible threats to the normal bearing of the child.

From the beginning of pregnancy itself, a woman is under special medical care. You can choose pregnancy management program“Trust”, which is offered by JSC “Family Doctor”. The program includes all necessary analyzes and studies. You can connect to the “Trust” program starting from any trimester.

Women over 35 years of age I need an annual appointment with a gynecologist. Age-related changes are a favorable factor for the development of many gynecological diseases, including such dangerous ones as genital cancer. Observation by a gynecologist will allow you to detect diseases in the early stages and begin their timely treatment.

During menopause the doctor will help eliminate the most unpleasant manifestations of menopausal syndrome and restore quality of life.

Treatment in acute cases

When do you need to see a gynecologist?

An appointment with a gynecologist is necessary in case of symptoms indicating diseases of the genital organs. Such symptoms may include pain in the lower abdomen, especially associated with menstruation or sexual activity, menstrual irregularities, itching and burning in the genital area, pain during urination or sexual intercourse, atypical discharge from the genitals and bleeding.

Education

In 1972 she graduated from MMI named after. I.M. Sechenov.

In 1977 she defended her thesis on the topic: “Reproductive function in patients with endometrioid ovarian cysts before and after treatment”; in 1985 - doctoral dissertation on the topic: “The state of the reproductive system of patients with benign tumors of the internal genital organs and the principles of its restoration after reconstructive plastic surgery.”

In 1993 L.V. Adamyan was awarded the academic title of professor. In 1999 she was elected a corresponding member of the Russian Academy of Medical Sciences, in 2004 - a full member of the Russian Academy of Medical Sciences; Member of the Bureau of Clinical Medicine Department of the Russian Academy of Medical Sciences.

In 2002, L.V. Adamyan was awarded the title “Honored Scientist of the Russian Federation” and awarded the Russian Government Prize in the field of science and technology for the introduction of endoscopic technology in gynecology.

Experience

Since 1976, she worked at the Center as a junior and senior researcher in the department of operative gynecology.

From April 1989 to the present, L.V. Adamyan has been the head of the department of operative gynecology of the Center; from December 28, 2006 to January 18, 2007, she was also the director of the Center.

Since 2002 L.V. Adamyan is the head of the Department of Reproductive Medicine and Surgery of the Federal Faculty of Education and Science of Moscow State Medical University.

Scientific activities

Adamyan L.V. - one of the country's leading obstetricians and gynecologists, whose sphere of scientific and practical interests covers all aspects of reproductive health from embryogenesis to postmenopause. She has conducted fundamental scientific research into the pathogenesis of various aspects of pathological processes in the human reproductive organs. Fluent in the techniques of traditional and latest surgical techniques, L.V. Adamyan supervises and coordinates scientific research to improve the technique of reconstructive plastic surgery in obstetrics and gynecology, actively develops the direction of minimally invasive surgery and the use of new technologies in operative gynecology.

L.V. Adamyan has 19 copyright certificates for various inventions in the field of operative gynecology, she has developed her own surgical techniques, which she has repeatedly demonstrated at international congresses in Italy, the USA, Great Britain, and Belgium. Adamyan L.V. carries out extensive medical work, provides advisory and medical assistance in various medical institutions in Moscow and other cities, travels to complex cases, and participates in consultations.

Results of scientific activities of L.V. Adamyan are presented in 968 publications in domestic and foreign publications, including 14 monographs and manuals, 5 atlases, 11 chapters. L.V. Adamyan created a scientific and clinical school of gynecologists, recognized in 2006 as the leading school in the specialty within the framework of the federal target scientific and technical program “Research and development in priority areas of development of science and technology,” the representatives of which head the departments of medical universities, medical institutions and clinical units hospitals and medical centers both in Russia and in countries near and far abroad.

Under the leadership of L.V. Adamyan, 48 candidate and doctoral dissertations have been completed, 21 works are being carried out. L.V. Adamyan carries out extensive scientific and organizational work as a member of the Academic Council of MGMSU, NC AGiP, Moscow Medical Academy, member of the Problem Commission of the Scientific Council of the Russian Academy of Medical Sciences and the Ministry of Health and Social Development for Obstetrics and Gynecology. Under the leadership of L.V. Adamyan, joint scientific research is being conducted with the universities of Oxford (Great Britain) and Leuven (Belgium).

L.V. Adamyan is the president of the Society of Reproductive Medicine and Surgery and the Russian Association of Endometriosis, vice-president of the National Association of Gynecologists and Endoscopists of Russia. Under her leadership, over the past 16 years, these associations have organized and held on the basis of the NC AGIP 20 International courses, seminars and congresses on various aspects of gynecology, which were attended by more than 10,000 participants, and in 2006 - the First International Congress on Reproductive Medicine, in which More than 2,200 doctors from Russia, near and far abroad countries and more than 50 international experts took part.

Under the leadership of L.V. Adamyan, on the basis of the Department of Operative Gynecology and the Department of Reproductive Medicine and Surgery of the FPDO MGMSU, residents and doctors are trained in the workplace, gynecologists from all regions of Russia undergo educational certification courses, on-site cycles and telemedicine sessions are conducted. As a member of the presidiums of the International and European Societies of Gynecological Endoscopy, the American Association of Gynecological Laparoscopists, the International Academy of Reproductive Medicine, the International Society of Pelvic Surgeons, L.V. Adamyan takes an active part in domestic and international symposiums.