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Medications for Maternity Hospitals and Perinatal Centers

Challenges

Extraordinary stress has become a part of life for many people in Ukraine since the beginning of the war. The war has also posed a significant challenge for pregnant women. In the early months of the war, women often found themselves giving birth in basements and bomb shelters, without access to proper medical assistance, in facilities under fire, and during disruptions of utilities such as electricity, water, and heating due to heavy artillery and missile shelling. Persistent stress and limited access to medical care, especially in frontline areas, continue to increase the risk of premature births.

Official statistics on maternal health in Ukraine, unfortunately, do not paint the full picture. Figures on premature births can be misleading, as many pregnant women, especially those with health problems, have been evacuated abroad. However, doctors, especially in areas bordering conflict zones, have reported an increase in premature births, cases of high blood pressure during pregnancy, and an elevated rate of cesarean sections, considering complications as a result of extraordinary stress in conditions of danger and displacement. According to the "Institute of Pediatrics, Obstetrics, and Gynecology of the NAMS of Ukraine," in just 9 months of the war in 2022, the number of premature births reached 9,000, which is 2,000 more than the same period in 2021 (excluding data from Luhansk and Kherson regions), although the overall number of births in 2022 decreased by 36,000 compared to the previous year.

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Giving birth during a war is a significant trial, and being born prematurely and under such difficult circumstances is a double challenge. Children born prematurely have a higher likelihood of developing complications in the respiratory, neurological, and digestive systems. The problems with preterm birth go beyond just low birth weight. A preterm baby is, above all, an immature baby, and the earlier it is born, the greater the anatomical and functional immaturity of various systems, hence the greater the need for their support.

According to Tetiana Znamenska, the president of the Association of Neonatologists of Ukraine, the key to saving prematurely born children includes modern high-tech medical equipment, quality medical drugs, and qualified specialists. The first two points require constant effort and significant funds.

That is why our goal was to help families of prematurely born children and provide vulnerable infants who cannot survive without special assistance with the necessary medications for treatment. We have supplied the following medications to hospitals in Ukraine:

Aminoven and Smoflipid

- used in the intensive care of newborns who require parenteral nutrition to meet their daily protein and fat needs.

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In most cases, prematurely born children and children with pathologies experience complications in the nervous, respiratory, digestive systems, etc. Intravenous nutrition is the only way for many of them to receive nutrients from the first days of life. Aminoven satisfies the body's protein needs, while Smoflipid serves as a primary source of energy, essential fatty acids, and omega-3 unsaturated fatty acids. These are the only registered drugs in Ukraine adapted for preterm infants and newborns.

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Kanavit (Vitamin K1)

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- used for the prevention of hemorrhagic complications in newborns. 

The risk of bleeding in the first days of life is often associated with a vitamin K deficiency, which is not uncommon among newborns. For the prevention of bleeding, according to the Order of the Ministry of Health of Ukraine No. 152 "Protocol for the medical care of a healthy newborn," the mandatory use of the Kanavit is recommended in all maternity hospitals within the first 24 hours of child’s life.

Dobutamine

- used to improve hemodynamics and reduce manifestations of myocardial dysfunction in newborns.

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Due to the immaturity of organs in preterm infants, critical disturbances in cardiac rhythm can occur at any time. Cardiovascular insufficiency more often arises in the first stage of a preterm baby's life but can also occur later, for example, during a severe infection. The main problem is hypotonia, i.e., too low blood pressure. The treatment of such disorders includes infusion therapy and drugs from the catecholamine group, to which Dobutamine belongs.

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Caffeine Citrate

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- a medication used to treat respiratory disorders in prematurely born children. It is most commonly applied in neonatology to prevent and treat primary apnea.

Establishing proper respiratory function is one of the main challenges in preterm infants. Approximately 25% of preterm infants experience apnea. To ensure the normal functioning of the lungs in the first hours of a preterm baby's life, doctors use Caffeine Citrate. The medication helps prematurely born children breathe freely and independently by stimulating the central nervous system.

Project Results

Prevention of common complications in prematurely born babies

Thanks to our partnership with the Americares Foundation, 78 hospitals across the country have received essential medications for the treatment and prevention of complications that often arise in prematurely born children—respiratory disorders, heart failure, and internal bleeding. These medications include Caffeine Citrate, Kanavit, and Dobutamine.

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Project delivered in partnership with:
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Крила надії
Access to free parenteral nutrition medications for vulnerable families
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Project delivered in partnership with:
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In collaboration with the humanitarian organization Alight, we have provided access to free parenteral nutrition drugs for vulnerable families. Prematurely born children have an increased need for nutrition as they must catch up on development and compensate for resource expenditures, learning to eat independently—a significant burden for these infants. Therefore, they require special fat and vitamin solutions, hydrolyzed, and amino acid mixtures. These medications are expensive but essential.

Thanks to the support from Alight, 15 hospitals have received vital parenteral nutrition drugs, and the smallest patients in these hospitals were able to receive Aminoven and Smoflipid free of charge.

Story of impact

Lviv Perinatal Center 

Tiny Artur was born prematurely, at 23 weeks of pregnancy, weighing 580 g.

The boy spent the first month of his life in the department of anesthesiology and neonatal intensive care, where he received highly specialized treatment and took vital medications:

- Surfactant to trigger lung function;

- Caffeine citrate for the prevention of apnea (breathing stops); - Canavit (vitamin K) for the prevention of hemorrhagic disease (bleeding);

- Cardiotonic Dobutamine.

Thanks to the joint actions of the Americares Foundation, UA Brokers Without Borders and Charitable Foundation "Wings of Hope", the hospital is supplied with all these medications. In 2022, more than 400 babies like Artur, prematurely born at different gestational ages, were treated in the Lviv perinatal center. Every single one requires specialized treatment. 

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Lviv Regional Clinical Hospital

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Meet the little heroes, Maxim and Danilko, still tiny. The boys were born with profound immaturity of all organs and systems, weighing 640 grams and 1000 grams at birth. The infants required prolonged treatment and care at the Neonatal Center of the Lviv Regional Clinical Hospital. The babies underwent a challenging path to relative stabilization during the first month after birth. It is crucial to receive treatment with necessary medications at this stage

"For over a decade, the Neonatal Intensive Care Unit of the Lviv Regional Clinical Hospital has been treating children of all weight categories, starting from a birth weight of 500 grams. These patients usually require prolonged comprehensive treatment over several months and continuous monitoring of all vital functions. Tiny patients need respiratory stimulation with caffeine citrate, prevention of significant bleeding with Kanavit, and inotropic support with Dobutamine," said the head of the department, Zoryana Salabay.

Thanks to the assistance of the Americares Foundation, UA Brokers Without Borders, and the Charitable Foundation "Wings of Hope", the hospital received all the necessary medications.

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