Современные исследования об эффективности и безопасности методов профилактики преждевременных родов
Проблема сохранения каждой желанной беременности актуальна в нашей стране в связи со сложной демографической ситуацией. Показатели смертности детей, рожденных до срока, остаются высокими. Данные исследований по профилактике преждевременных родов (ПР) путем введения прогестерона женщинам с факторами риска (ПР в анамнезе, короткая шейка матки, многоплодие) разнородны. Предпочтительно влагалищное введение микронизированного прогестерона. Серкляж показал эффект только при одноплодной беременности с предшествующими спонтанными ПР в комбинации с короткой шейкой матки. Данных за профилактический серкляж при многоплодной беременности нет даже в случаях с укорочением шейки матки. Экстренный серкляж остается показанием после индивидуальной консультации. Эффект цервикального пессария при одноплодной и многоплодной беременности у пациенток с риском ПР представляется перспективным по сравнению с другими вариантами вторичной профилактики, когда терапия начинается на ранних стадиях преждевременного созревания шейки матки. Перспективны подходы, связанные с питанием и приемом биологически активных добавок для профилактики ПР (цинк, витамин D, докозогексаеновая кислота). Отказ от курения до беременности является эффективной мерой профилактики ПР.Габитова Н.А., Кедрова А.Г., Дикке Г.Б., Белоусова Т.Н., Малышева О.Г.
Заключение. Решения в пользу выбора того или иного метода профилактики ПР должны приниматься индивидуально в каждом конкретном случае.
Ключевые слова
беременность
преждевременные роды
прогестерон
серкляж
пессарий
питание
биологически активные добавки
курение
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Об авторах / Для корреспонденции
Автор для связи: Наталия Алексеевна Габитова, д.м.н., профессор кафедры акушерства и гинекологии Академии постдипломного образования, Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий ФМБА, Москва, Россия; gabitova_nataliya@mail.ru; eLibrary SPIN: 4812-3600
ORCID:
Н.А. Габитова (N.A. Gabitova), https://orcid.org/0000-0003-2278-2624
А.Г. Кедрова (A.G. Kedrova), https://orcid.org/0000-0003-1031-9376
Г.Б. Дикке (G.B. Dikke), https://orcid.org/0000-0001-9524-896
Т.Н. Белоусова (T.N. Belousova), https://orcid.org/0000-0003-3804-76-91
О.Г. Малышева (O.G. Malysheva), https://orcid.org/00009-00009-6089-7589
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