mvjrМедицинский вестник Юга РоссииMedical Herald of the South of Russia2219-80752618-7876The Rostov State Medical University10.21886/2219-8075-2024-15-2-25-32mvjr-1895Research ArticleАКУШЕРСТВО И ГИНЕКОЛОГИЯOBSTETRICS AND GYNECOLOGYНерешённые вопросы прогнозирования поздних преждевременных родовRisk factors and the possibility of predicting late premature birthhttps://orcid.org/0000-0003-0361-2785ФаткуллиннаЛ. С.FatkullinaL. S.

Фаткуллина Лариса Сергеевна - к.м.н., доцент кафедры акушерства и гинекологии имени профессора В.С. Груздева.

Казань

Larisa S. Fatkullina - Cand. Sci. (Med.), Associate Professor of the Department of Obstetrics and Gynecology n. a. V.S. Gruzdev.

Kazan

fatkullinalara@gmail.comhttps://orcid.org/0000-0001-9673-9077ФаткуллинИ. Ф.FatkullinI. F.

Фаткуллин Ильдар Фаридович - д.м.н., профессор кафедры акушерства и гинекологии им. проф. В.С. Груздева.

Казань

Ildar F. Fatkullin - Dr. Sci. (Med.), Professor of the Department of Obstetrics and Gynecology n. a. V.S. Gruzdev.

Kazan

fatkullin@yandex.ruhttps://orcid.org/0000-0002-0645-2791КнязевС. А.KnyazevS. A.

Князев Сергей Александрович - к.м.н., ассистент кафедры акушерства и гинекологии с курсом перинатологии, Медицинский институт, РУДН; Городская клиническая больница им. Е.О. Мухина Департамента здравоохранения Москвы.

Москва

Sergey A. Knyazev - Cand. Sci. (Med.), Associate Professor, Department of Obstetrics and Gynecology Medical Institute, RUDN University; City Clinical Hospital n. a. E.O. Mukhin.

Moscow

sergei.kniazev@praesens.ruКазанский государственный медицинский университетРоссияKazan State Medical UniversityRussian FederationМедицинский институт, Российский университет дружбы народов; Городская клиническая больница им. Е.О. Мухина Департамента здравоохранения МосквыРоссияMedical Institute, Peoples’ Friendship University n. a. Patrice Lumumba; City Clinical Hospital named after E.O. MukhinRussian Federation2024150620241522532Copyright © Фаткуллинна Л.С., Фаткуллин И.Ф., Князев С.А., 20242024Фаткуллинна Л.С., Фаткуллин И.Ф., Князев С.А.Fatkullina L.S., Fatkullin I.F., Knyazev S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medicalherald.ru/jour/article/view/1895

В структуре преждевременных родов более половины случаев приходится на поздние преждевременные роды (ППР). Многие аспекты этой проблемы остаются неизученными. В статье проведён анализ литературных источников с 2018 по 2023 гг. (отечественные и зарубежные научные исследования, мета-анализы и систематические обзоры), которые посвящены поздним преждевременным родам. Рассмотрены факторы риска, прогнозирование и стратегии управления при преждевременных родах в период с 34 до 36⁺⁶ недель беременности. Понимание факторов риска и возможности прогнозирования являются важными для предотвращения поздних ПР и улучшения исходов беременности. Для удобства использования, факторы риска и прогностические критерии сведены в таблицы с указанием литературных источников и OR. На основании проанализированных данных составлен примерный портрет пациентки с поздними преждевременными родами и подтверждено значение биохимических маркеров (PAMG-1 и фибронектина), а также инструментальных методов (цервикометрии и эластографического ультразвукового исследования шейки матки) как наиболее информативных тестов-предикторов наступления ППР. Оптимальным представляется оценка рисков с использованием нескольких методов прогнозирования наступления преждевременных родов. Приведённые в данной статье сведения позволяют провести правильную оценку рисков преждевременных родов, включая поздние ПР и определить тактику ведения, основанную на использовании информативных и «быстрых» тестов на угрожающие ПР, что позволит улучшить их исходы.

In the structure of preterm labor, more than half of the cases occur in late preterm labor. Many aspects of this problem remain unexplored. The article analyzes the literature sources from 2018 to 2023 (domestic and foreign scientific studies, meta-analyses, and systematic reviews) devoted to late premature birth. Risk factors, prognosis, and management strategies for preterm birth in the period from 34 to 36 weeks of pregnancy are considered. Understanding risk factors and predictive capabilities are important to prevent late pregnancy and improve pregnancy outcomes. For ease of use, risk factors and prognostic criteria are summarized in tables with references and OR. Based on the analyzed data, an approximate portrait of a patient with late premature birth was compiled and the value of biochemical markers (PAMG-1 and fibronectin), as well as instrumental methods - cervicometry and elastography ultrasound examination of the cervix, as the most informative predictor tests of the onset of late preterm birth was confirmed. It seems optimal to assess risks using several methods for predicting the onset of premature birth. The information provided in this article allows for a correct assessment of the risks of premature birth, including late delivery, and to determine management tactics based on the use of informative and "fast" tests for threatening deliveries, which will improve their outcomes.

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The authors declare that there are no conflicts of interest present.