scholarly journals Possibilities for diagnosis and prediction of preterm labor at the present stage

2021 ◽  
Vol 102 (1) ◽  
pp. 47-59
Author(s):  
V A Mudrov ◽  
A M Ziganshin ◽  
A G Yashchuk ◽  
L A Dautova ◽  
R Sh Badranova
Keyword(s):  
Preterm Birth ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Bibliographic Databases ◽  
Modern World ◽  
Perinatal Morbidity ◽  
Spontaneous Preterm Birth ◽  
Risk Of Death ◽  
Premature Babies ◽  
Gynecology And Obstetrics

Preterm birth is one of the main causes of perinatal morbidity and mortality, which does not tend to decrease in rate. The risk of death in premature babies is 2535 times higher than that of full-term babies, and stillbirths are registered 813 times more often than in timely delivery. To date, there are no effective ways to prevent preterm birth. Therefore, the timeliness of therapy, which largely determines the outcome of pregnancy in general, depends on the effectiveness of assessing the likelihood of their development. At the International Federation of Gynecology and Obstetrics (FIGO) Congress (2018), preterm birth is identified as a problem that has not yet been solved at the current stage of science and technology development. The result of the unsolved problems is a situation wherein the modern world over the past 60 years there has been no decrease in the premature birth rate, which is 9.5% of births and annually ends with the birth of 15,000,000 premature babies. The study aimed to research modern methods of diagnosis and prediction of spontaneous preterm birth. An analytical method was used in the study: a detailed systematic analysis of modern domestic and foreign literature on the diagnosis and prognosis of preterm birth. We used eLibrary, Scopus, PubMed, MEDLINE, ScienceDirect, Cochrane Library bibliographic databases (until August 2020). The article deals with the diagnosis and prediction of preterm birth probability, which will optimize the management of patients from the risk group and, in the future, will reduce the rate of perinatal morbidity and mortality of premature babies. Despite a significant number of researches devoted to the study of possibilities for diagnosing and predicting spontaneous preterm birth, currently, there are no methods with absolute diagnostic value. Most -existing studies indicate that when assessing the probability of preterm birth, a comprehensive approach should be preferred taking into account the results of several main and additional methods.

scholarly journals 17-Alpha-Hydroxyprogesterone vs. Placebo for Preventing of Recurrent Preterm Birth: A Systematic Review and Meta-Analysis of Randomized Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Abdulaali R. Almutairi ◽  
Hadir I. Aljohani ◽  
Nouf S. Al-fadel
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Meta Analysis ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Relative Risk Ratio ◽  
Analysis Model ◽  
Clinical Trial Registries

Background: Preterm birth (PTB) is a leading cause of neonatal morbidity and mortality.Objective: To estimate the effect of 17-alpha-hydroxyprogesterone caproate (17-OHPC) compared to placebo in singleton gestations for reducing the risk of recurrent PTB and neonatal morbidity and mortality.Work Design: Systematic review and meta-analysis.Search Strategy: Searching MEDLINE, Embase, Web of Science, SCOPUS, Cochrane Library, and clinical trial registries.Selection Criteria: Randomized controlled trials of singleton gestations with a history of PTB and treated with a weekly intramuscular injection of 17-OHPC or placebo.Data Collection and Analysis: A random meta-analysis model was performed for the PTB outcomes (<32, <35, and <37 weeks) and neonatal outcomes (neonatal death, grade 3 or 4 intraventricular hemorrhage, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, and sepsis). Effect estimates were measured by relative risk ratio (RR) with a 95% confidence interval (CI).Main Results: Six works were included. There were no statistically significant reductions in the PTB risk following the use of 17-OHPC at <32 weeks (RR = 0.61, 95% CI: 0.13–2.77, and I2 = 39%), <35weeks (RR = 0.60, 95% CI: 0.10–3.67, and I2 = 51%), and <37 weeks (RR = 0.68, 95% CI: 0.46–1, and I2 = 75%). Furthermore, all the neonatal outcomes were statistically similar between the two groups.Conclusion: Treatment with 17-OHPC is not associated with reducing the risk of PTB or neonatal outcomes compared to placebo.

scholarly journals Biochemical Markers As Predictor Of Preterm Labor- Their Clinical Relevance And The Current Status

2020 ◽  
Author(s):  
Suneeta Singh ◽  
Madhusudhan Dey ◽  
Sanjay Singh ◽  
Shibu Sasidharan
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Preterm Labor ◽  
Biochemical Markers ◽  
Preterm Births ◽  
Current Status ◽  
Perinatal Morbidity ◽  
Spontaneous Preterm Birth ◽  
Fetal Fibronectin ◽  
Asymptomatic Women

Preterm birth is associated with significant perinatal morbidity and mortality. Spontaneous preterm birth accounts for upto 75% of all preterm births. A number of maternal and fetal characteristics have been associated with preterm birth. With better understanding of the pathophysiology of preterm birth, various biochemical markers have been studied extensively to predict the preterm birth efficiently so as to intervene appropriately and timely in the cases that would benefit from treatment. This paper provides a summary of the current literature on the use of biochemical markers in predicting spontaneous preterm birth in symptomatic and high risk-asymptomatic women. Evidence from the literature suggests cervico vaginal fetal fibronectin,interleukin-6, phosphorylated Insulin-like growth factor binding protein-1(phIGFBP1), placental alpha macroglobulin-1 (PAMG-1) and serum

scholarly journals Infection and preterm birth

2008 ◽  
Vol 29 (4) ◽  
pp. 212
Author(s):  
Helen McDonald
Keyword(s):  
Preterm Birth ◽  
Neonatal Care ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Late Miscarriage

Preterm birth (PTB) before 37 weeks? gestation remains an important cause of perinatal morbidity and mortality, despite modern advances in obstetric and neonatal care. The causes of spontaneous PTB are multi-factorial; however, infection has been implicated as a significant cause of both PTB and late miscarriage, often with no visible signs or symptoms.

scholarly journals C-REACTIVE PROTEIN LEVELS - INDICATOR FOR PROGNOSIS OF SPONTANEOUS PRETERM BIRTH IN BULGARIAN WOMEN

2021 ◽  
Vol 2 ◽  
pp. 80-86
Author(s):  
Iliana Koleva-Korkelia ◽  
Yanka Karamalakova
Keyword(s):  
Preterm Birth ◽  
Maternal Age ◽  
Clinical Settings ◽  
Spontaneous Preterm Birth ◽  
Protein Levels ◽  
Reactive Protein ◽  
Premature Babies ◽  
Active Labor ◽  
The Relationship ◽  
Control Study

It is estimated that every year fifteen million premature babies are born worldwide mainly due to spontaneous preterm birth (sPTB). Furthermore, in clinical settings, there still are no reliable and accurate tools to predict preterm labor. Hence, the aim of this pioneering research was to estimate the relationship between the maternal inflammatory indicator and sPTB in a case-control study between 220 South Bulgarian women. The study was conducted at UMBAL, Stara Zagora, Bulgaria (2017-2020) and enrolled a total of 220 women, determined into two groups: 1) TB (n = 110), who were to give birth at term ≥ 37 to ≤ 39 + 6 gestation weeks with active labor at the time of hospitalization; and 2) sPTB (n = 110), women with preterm birth ≤ 32–34 + 6 gestation weeks and declared active labor, who were to give birth within 5-24 hrs. The inflammatory indicators/CRP concentration was quantified in plasma by immunoturbidimetric methods within 2 hrs. in mg/l. The median maternal CRP (8.77 ± 3.91), with cutoff = 4.9 mg/l was identified as optimal inflammation with highest risk of sPTB (sensitivity = 86.6%; specificity = 53.7%, р < 0.0001). Moreover, a cutoff CRP = 4.9 mg/l was found to be most effective in determining maternal age ≤ 19 years, the sensitivity of 68.6%, and positively correlated OR = 8.122 vs. OR = 2.354, with increased total sPTB risk at ≤ 32-34 + 6 weeks, respectively (p < 0.001). In conclusion, increased CRP concentrations and a decreased maternal age were associated with increased risks of sPTB, before ≤ 32-34 + 6 weeks. Minimal inflammation and other factors in combination may also act as sPTB prognosis.

scholarly journals Preterm birth: from understanding of pathogenesis to pregnancy management

2019 ◽  
Vol 12 (4) ◽  
pp. 47-51
Author(s):  
V. S. Belousova ◽  
A. N. Strizhakov ◽  
E. V. Timokhina ◽  
O. A. Svitich ◽  
I. M. Bogomazova ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gene Polymorphism ◽  
Preterm Delivery ◽  
Inflammatory Cytokines ◽  
Morbidity And Mortality ◽  
Gestation Period ◽  
Perinatal Morbidity ◽  
Cytokine Gene ◽  
Cytokine Gene Polymorphism ◽  
Pro Inflammatory Cytokines

Preterm birth is an important issue in the current obstetrics as it is associated with perinatal morbidity and mortality. Today, most studies are aimed at understanding of the pathogenesis of preterm delivery. The known data on cytokine gene polymorphism indicate that in women with preterm birth, the presence of pro-inflammatory dominant alleles is typical. This may lead to increased production of pro-inflammatory cytokines in the utero-placental complex and may also initiate preterm delivery. At present, studies are under way to identify genes that determine the duration of the gestation period. A better understanding of the preterm birth pathogenesis is expected to help prevent this unfortunate outcome and decrease perinatal morbidity and mortality.

Preterm Birth, Inflammation and Infection: New Alternative Strategies for their Prevention

2019 ◽  
Vol 20 (5) ◽  
pp. 354-365 ◽  
Author(s):  
Víctor M. Muñoz-Pérez ◽  
Mario I. Ortiz ◽  
Raquel Cariño-Cortés ◽  
Eduardo Fernández-Martínez ◽  
Leticia Rocha-Zavaleta ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Medicinal Plants ◽  
Low Income ◽  
Experimental Studies ◽  
Neonatal Outcomes ◽  
New Drugs ◽  
Alternative Strategies ◽  
Mortality And Morbidity ◽  
Therapeutic Benefits ◽  
Gynecology And Obstetrics

Background:Worldwide, the progress in reducing neonatal mortality has been very slow. The rate of preterm birth has increased over the last 20 years in low-income and middle-income countries. Its association with increased mortality and morbidity is based on experimental studies and neonatal outcomes from countries with socioeconomic differences, which have considered implementing alternative healthcare strategies to prevent and reduce preterm births.Methods:Currently, there is no widely effective strategy to prevent preterm birth. Pharmacological therapies are directed at inhibiting myometrial contractions to prolong parturition. Some drugs, medicinal plants and microorganisms possess myorelaxant, anti-inflammatory and immunomodulatory properties that have proved useful in preventing preterm birth associated with inflammation and infection.Results:This review focuses on the existing literature regarding the use of different drugs, medicinal plants, and microorganisms that show promising benefits for the prevention of preterm birth associated with inflammation and infection. New alternative strategies involving the use of PDE-4 inhibitors, medicinal plants and probiotics could have a great impact on improving prenatal and neonatal outcomes and give babies the best start in life, ensuring lifelong health benefits.Conclusion:Despite promising results from well-documented cases, only a small number of these alternative strategies have been studied in clinical trials. The development of new drugs and the use of medicinal plants and probiotics for the treatment and/or prevention of preterm birth is an area of growing interest due to their potential therapeutic benefits in the field of gynecology and obstetrics.

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