DOI: https://doi.org/10.18370/2309-4117.2020.51.56-59

Modern possibilities of preterm birth prediction

M. Hychka, V. O. Beniuk, V. M. Goncharenko, O. A. Dyndar, V. F. Oleshko

Abstract


Purpose of the study is to improve the method of preterm deliveries onset predicting in pregnant women at 24–34 weeks.

Materials and methods. 49 pregnant women with gestational age 24–34 weeks and with diagnosis of “threatening premature deliveries" were comprehensively examined using transvaginal ultrasound. Pregnant women with a shortened cervix ≤25 mm were given a qualitative determination of fetal fibronectin. The average age of pregnant women ranged from 26–34 years and averaged out 31.2 ± 0,6 years.

Study results. Clinically significant structural changes in the cervix were only in 21 (42.9%) pregnant women. The average value of the cervix length varied between 16–24 mm and averaged 18.2 ± 0.4 mm. Positive test on fetal fibronectin in vaginal secretions was in 7 (33.3%) of 21 pregnant women with clinically significant structural changes in the cervix. During 10 days premature birth occurred in 3 (42.9%) of 7 pregnant women with clinically significant cervix shortening and a positive test for fetal fibronectin in the gestation period of 32 weeks. Hospitalization in an obstetric hospital was found to be unjustified in 28 (57.1%) cases.

Conclusions. Combination of a comprehensive assessment of the cervix state and vaginal fetal fibronectin evaluation in pregnant women with risk of preterm deliveries at the outpatient stage allows to predict the manifestation of preterm birth in critical terms also determine the volume and direction of therapy in obstetric department. Combination of this methods help to prevent unwarranted hospitalization of a pregnant woman in an obstetric hospital and as a result it limits the conduct of glucocorticoid therapy and prevent a prolong stay of a pregnant woman in a hospital and the associated contamination with nosocomial bacteria strains.


Keywords


pregnancy; cervical condition; fetal fibronectin; premature deliveries; transvaginal sonography

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References


Ajlamazjan, J.K. “Debatable problems of premature birth and nursing of children with extremely low body weight”. Journal of Obstetrics and Women's Diseases 9.3 (2011): 183–9.

Baranov, I.I., Skripnichenko, Y.P., Tokova, Z.Z., Kuzmich, I.N. “Medical and social aspects of preterm birth.” Gynecology 5 (2014): 90–3.

Beniuk, V.O., Dyndar, O.A. “Cytokine profile and immunohistochemical state of the endometrium of women with habitual miscarriage on the background of overweight, metabolic syndrome.” Immunology and Allergology: Science and Practice 4 (2014): 33–7.

K.V., Juzko, O.M. “Predicting preterm birth: realities and prospects.” Neonatology, surgery and perinatal medicine 4.26 (2017): 87–90.

Zhuk, S.I., Us, I.V., Bykova, O.G., Pehnio, N.V. “Comparative characteristics of various methods of laboratory diagnostics of premature birth.” Health of Women 5.101 (2015): 38–40.

Oleksienko, I.V., Chaika, G.V., Zaslavska, M.G., Prolygina, I.V. “Modern view of the etiology, diagnosis and treatment of cervical isthmic-cervical insufficiency (literature review).” Visnyk Vinnyckogo nacionalnogo medychnogo universytetu 1.20 (2016): 137–140.

Patent UA 115797. Method for predicting changes in the state of the cervix in pregnant women with isthmic-cervical insufficiency. Ukrainian Patent Database: 5 p.

Podzolkova, N.M., Tatarchuk, T.F., Doshchanova, A.M., et al. “Menstrual cycle normalization with dydrogesterone.” Akusherstvo i Ginekologiya (Russian Federation) 6 (2018): 70–5.

Radzinskij, V.E. Obstetric aggression. Moscow. Publishing house of the “StatusPraesens” Journal (2011): 668 p.

Romanenko, T.G., Melnychuk, I.P. “Isthmic-cervical insufficiency: diagnostics, pregnancy management tactics, correction methods (analytical literature review).” Health of Women 1 (2014): 41–6.

Serov, V.N., Sukhorukova, O.Y. “The effectiveness of the prevention of premature birth.” Obstetrics and Gynecology 3 (2013): 48–53.

Tatarchuk, T., Zakharenko, N., Bachynska, I., Kosey N. “On the issue of autoimmune ovary damage during puberty.” Georgian medical news 279 (2018): 49–56.

Ushakova, G.A. “About the quality of life, rights and fate of a person born with an extremely low body weight.” StatusPraesens 3.9 (2012): 11–3.

Shcherbina, N.A., Skorbach, E.I., et al. “Pregnancy outcomes in conservative and surgical correction of isthmic-cervical insufficiency.” Molodyj vchenyj 7.10 (2014): 5–7.

Berghella, V., Hayes, Е., Visintine, J. “Fetal fibronectin testing for reducing the risk of preternbirts”. Cochrane Database Syst Rev 4 (2008): 1–8. DOI: 10.1002/14651858.CD006843.pub2

Claire, F., Shennan, A.H. “Fetal fibronectin as a biomarker of preterm labor: a review of the literature and advances in its clinical use.” Biomarkers Med 8.4 (2014): 471–84.

Deshpande, S.N., van Asselt, A.D.I., Tomini, F., et al. Rapid fetal fibronectin testing to predict preterm birth in women with symptoms of premature labour: a systematic review and cost analysis. National Institute for Health Research (2013): 161 p. DOI: 10.3310/hta17400

Flood, K., Malone, F.D. “Prevention of preterm birth”. Seminars in fetal & neonatal medicine 17.1 (2011): 58–63.

Fuchs, F., Lefevre, C., Senat, M., Fernandez, H. “Accuracy of fetal fibronectin for the prediction of preterm birth in symptomatic twin pregnancies: a pilot study”. Scientific Reports 8 (2018): 2160.

Kiss, H., Petricevic, L., Husslein, P. “Reducing the rate of preterm birth through a simple antenatal screen-and-treat programme: a retrospective cohort study.” European journal of obstetrics & gynecology and reproductive biology 153 (2010): 38–42.

Leitich, H., Kaider, А. “Fetal fibronectin – How useful is it in the prediction of preternbirts?” BJOG 110.20 (2003): 66–70.

Mazza, E., Parra-Saavedra, M., Bajka, M., et al. “In vivo assessment of the biomechanical properties of the uterine cervix in pregnancy.” Prenatal Diagnosis 34 (2014): 33–41.

Michael S. Ruma, Katie C. Bittner, Clara B. Soh.“Current Perspectives on the Use of Fetal Fibronectin Testing in Preterm Labor Diagnosis and Management.” Am J Manag Care 23 (2017): 356–62.

Norman, J.E., Marlow, N., Messow, C.M., Shennan, A. “Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study): a multicentre, randomized, double-blind trial.” Lancet 387 (2016): 2106–16.

Riboni, F., Vitulo, A., Plebani, M. “Biochemical markers for predicting preterm birth.” Medical Aspects of Women's Health 6 (2013): 34–9.


GOST Style Citations


1.            Айламазян, Э.К. Дискуссионные проблемы преждевременных родов и выхаживания детей с экстремально низкой массой тела / Э.К. Айламазян // Журнал акушерства и женских болезней. – 2011. – № 9 (3). – С. 183–189.

2.            Баранов, И.И. Медицинские и социальные аспекты преждевременных родов / И.И. Баранов, Ю.П. Скрипниченко, З.З. Токова, И.Н. Кузьмич // Гинекология. – 2014. – № 5. – С. 90–93.

3.            Бенюк, В.О. Цитокіновий профіль і імуногістохімічний стан ендометрія жінок із невиношуванням вагітності на тлі надлишкової маси тіла та метаболічного синдрому / В.О. Бенюк, О.А. Диндар // Імунологія та алергологія: наука і практика. – 2014. –№ 4. –С. 33–7.

4.            Дяк, К.В. Прогнозування передчасних пологів: реалії і перспективи / К.В. Дяк, О.М. Юзько // Неонатологія, хірургія та перинатальна медицина. – 2017. – № 4 (26). – С. 87–90.

5.            Жук, С.І. Порівняльна характеристика різних методів лабораторної діагностики передчасних пологів / С.І. Жук, І.В. Ус, О.Г. Бикова, Н.В. Пехньо // Здоровье женщины. – 2015. –№ 5 (101). – С. 38–40.

6.            Олексієнко, І.В. Cучасний погляд на етіологію, діагностику та лікування істміко-цервікальної недостатності шийки матки (огляд літератури) / I.В. Олексієнко, Г.В. Чайка, М.Г. Заславська, І.Г. Пролигіна // Вісник Вінницького національного медичного університету. – 2016. – № 1 (20). –  С. 137–140.

7.            Патент UA 115797. Спосіб прогнозування змін стану шийки матки у вагітних з істміко-цервікальною недостатністю. База патентів України: 5 с.

8.            Подзолкова, Н.М. Нормализация менструального цикла дидрогестероном / Н.М. Подзолкова, Т.Ф. Татарчук, А.М. Дощчанова и др. // Акушерство и Гинекология (Российская Федерация). – 2018. – № 6. – С. 70–75.

9.            Радзинский, В.Е. Акушерская агрессия / В.Е. Радзинский. – М.: Изд-во журнала «StatusPraesens», 2011. – 668 c.

10.          Романенко, Т.Г. Істміко-цервікальна недостатність: діагностика, тактика ведення вагітності, методи корекції (аналітичний огляд літератури) / Т.Г. Романенко, І.П. Мельничук І.П. // Здоровье женщины. – 2014. – № 1. – С. 41–46.

11.          Серов, В.Н. Эффективность профилактики преждевременных родов / В.Н. Серов, О.И. Сухорукова // Акушерство и гинекология. – 2013. – № 3. – С. 48–53.

12.          Татарчук, Т. К вопросу об аутоиммунном поражении яичников в период полового созревания / Т. Татарчук, Н. Захаренко, И. Бачинская, Н. Косей // Грузинские медицинские новости. – 2018. – № 279. – С. 49–56.

13.          Ушакова, Г.А. О качестве жизни, правах и судьбе человека, родившегося с экстремально низкой массой тела / Г.А. Ушакова // StatusPraesens. – 2012. – № 3 (9). –С. 11–13.

14.          Щербина, Н.А. Исходы беременности при консервативной и хирургической коррекции истмико-цервикальной недостаточности / Н.А. Щербина, Е.И. Скорбач, Муавия Салем Насер Альмарадат, Д.В. Коломацкая  // Молодий вчений. – 2014. – № 7 (10). – С. 5–7.

15.          Berghella, V., Hayes, Е., Visintine, J. “Fetal fibronectin testing for reducing the risk of preternbirts”. Cochrane Database Syst Rev 4 (2008): 1–8. DOI: 10.1002/14651858.CD006843.pub2

16.          Claire, F., Shennan, A.H. “Fetal fibronectin as a biomarker of preterm labor: a review of the literature and advances in its clinical use.” Biomarkers Med 8.4 (2014): 471–84.

17.          Deshpande, S.N., van Asselt, A.D.I., Tomini, F., et al. Rapid fetal fibronectin testing to predict preterm birth in women with symptoms of premature labour: a systematic review and cost analysis. National Institute for Health Research (2013): 161 p. DOI: 10.3310/hta17400

18.          Flood, K., Malone, F.D. “Prevention of preterm birth”. Seminars in fetal & neonatal medicine 17.1 (2011): 58–63.

19.          Fuchs, F., Lefevre, C., Senat, M., Fernandez, H. “Accuracy of fetal fibronectin for the prediction of preterm birth in symptomatic twin pregnancies: a pilot study”. Scientific Reports 8 (2018): 2160.

20.          Kiss, H., Petricevic, L., Husslein, P. “Reducing the rate of preterm birth through a simple antenatal screen-and-treat programme: a retrospective cohort study.” European journal of obstetrics & gynecology and reproductive biology 153 (2010): 38–42.

21.          Leitich, H., Kaider, А. “Fetal fibronectin – How useful is it in the prediction of preternbirts?” BJOG 110.20 (2003): 66–70.

22.          Mazza, E., Parra-Saavedra, M., Bajka, M., et al. “In vivo assessment of the biomechanical properties of the uterine cervix in pregnancy.” Prenatal Diagnosis 34 (2014): 33–41.

23.          Michael S. Ruma, Katie C. Bittner, Clara B. Soh.“Current Perspectives on the Use of Fetal Fibronectin Testing in Preterm Labor Diagnosis and Management.” Am J Manag Care 23 (2017): 356–62.

24.          Norman, J.E., Marlow, N., Messow, C.M., Shennan, A. “Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study): a multicentre, randomized, double-blind trial.” Lancet 387 (2016): 2106–16.

25.          Riboni, F., Vitulo, A., Plebani, M. “Biochemical markers for predicting preterm birth.” Medical Aspects of Women's Health 6 (2013): 34–9.





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