Современные исследования об эффективности и безопасности методов профилактики преждевременных родов


DOI: https://dx.doi.org/10.18565/pharmateca.2023.4-5.8-15

Габитова Н.А., Кедрова А.Г., Дикке Г.Б., Белоусова Т.Н., Малышева О.Г.

1) Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий ФМБА, Москва, Россия; 2) Академия медицинского образования им. Ф.И. Иноземцева, Санкт-Петербург, Россия; 3) Видновский перинатальный центр, Видное, Московская область, Россия
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.
Заключение. Решения в пользу выбора того или иного метода профилактики ПР должны приниматься индивидуально в каждом конкретном случае.

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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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