Сучасні погляди на етіологію, патогенез і клінічний перебіг спонтанних передчасних пологів, тактику ведення та профілактику ускладнень (огляд літератури)

Abstract

A review of medical literature regarding modern views on premature birth, the main issues of etiology and pathogenesis of this pathology, diagnostic signs, clinical features of the course, management tactics and perinatal consequences, investigated prognostic markers. A review of the medical literature regarding modern views on premature birth, the main issues of etiology and pathogenesis of this pathology, diagnostic signs, clinical features of the course, management tactics and perinatal consequences, investigated prognostic markers is provided. Despite the active and relentless development of medical science, the issue of premature births and their impact on short- and long-term consequences for mothers and children remains an urgent issue. Purpose - to highlight the scientists’ understanding of the etiology, pathogenesis, clinical management of premature birth, as well as to examine the available data on promising tocolytic drugs and methods of predicting premature birth. Among the tocolytic drugs currently undergoing clinical trials, the following groups are distinguished - broad-spectrum chemokine inhibitors, prostaglandin F2α-receptor target drugs, interleukin 1 receptor antagonists, and nanoparticle platforms. If the research is successful, obstetricians and gynecologists may have a targeted drug for the treatment of preterm labor with a better safety profile than the range of drugs we have today. Research into new laboratory prognostic markers of preterm birth, such as pregnancy-associated plasma protein A, human chorionic gonadotropin, alpha-fetoprotein, estriol, ferritin, ceruloplasmin, alkaline phosphatase, hematological markers, is also ongoing. The implementation of the above prognostic markers in clinical medicine will allow obtaining new opportunities in the early prediction of premature birth. Sonographic approaches to predicting premature birth are being updated. In addition to the measurement of the length of the cervix, the measurement of the uterine-cervical angle and the use of cervical elastography are used. Modern scientific achievements will allow doctors in the future at earlier stages of pregnancy to predict the possibility of premature birth and more effectively treat premature birth that has begun. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.