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Obstetrics and Gynegology2022№5
Hyperandrogenism as a risk factor...

Hyperandrogenism as a risk factor for isthmicocervical insufficiency

DOI
https://dx.doi.org/10.18565/aig.2022.5.5-13

Levakov S.A., Mokh A.V., Sheshukova  N.A.

1) Department of Obstetrics and Gynecology, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia; 2) Perinatal Center, M.P. Konchalovsky City Clinical Hospital, Moscow Healthcare Department, Moscow, Russia
This literature review analyzes the factors that explain failures in the prediction, timely diagnosis, treatment, and prevention of one of the most important obstetric problems, such as miscarriage. It presents an update on neonatal morbidity and mortality, which are due to prematurity as a result of preterm birth.
Premature birth is considered as a complex multifactorial problem; the review underlines the importance of identifying risk factors for their development in different populations (body mass index calculation, weight gain during pregnancy, urinary steroid profile analysis, elastography, sociodemographic factors and others), which makes it possible to select appropriate preventive measures.
Overproduction of androgens is a potentially significant risk factor for preterm birth. There is a review of modern literature sources, which reflects trend priorities in assessing the relationship between hyperandrogenism and isthmicocervical insufficiency. There is information on main risk factors for maternal hyperandrogenism, its impact on pregnancy complications, and fetal outcomes. Consideration is given to the trigger mechanisms of isthmicocervical insufficiency and the cofactors that determine its therapy; there are diverse opinions about the importance of hyperandrogenism of various geneses in the development of miscarriage and complicated pregnancy. Attention is focused on the direct cause-and-effect relationship between hyperandrogenism and the development of isthmicocervical insufficiency.
Conclusion: The effectiveness of medical and surgical correction of isthmicocervical insufficiency is comparatively evaluated. Emphasis is laid on that the treatment policy for isthmicocervical insufficiency concurrent with hyperandrogenism should be differentiated and depends on many factors that today remain insufficiently studied in the world, by maintaining the risks of miscarriage.

Keywords

isthmicocervical insufficiency
hyperandrogenism
cerclage
miscarriage
Full text (in Russian)

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Received 15.02.2022

Accepted 28.03.2022

About the Authors

Sergey A. Levakov, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology of the N.V. Sklifosovsky ICM, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), levakoff@yandex.ru , 119991, Russia, Moscow, Trubetskaya str., 8-2.
Artur V. Mokh, obstetrician-gynecologist at the Maternity Department, M.P. Konchalovsky City Clinical Hospital, Perinatal Center,
124617, Moscow, Zelenograd, Alexandrovka str., 8.
Natalia A. Sheshukova, Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology of the N.V. Sklifosovsky ICM, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), dr.sheshukova@mail.ru, 119991, Russia, Moscow, Trubetskaya str., 8-2.

Authors' contributions: Levakov S.A. – the investigation supervisor; Mokh A.V. – selection of patients for the investigation, maintaining a patient database, statistical processing of the results, writing the text; Sheshukova N.A. – the research idea, development of the design of the investigation, editing the text.
Conflicts of interest: The authors of this article have declared that there are no conflicts of interest to be informed.
Funding: The investigation has been conducted without additional funding.
For citation: Levakov S.A., Mokh A.V., Sheshukova N.A.
Hyperandrogenism as a risk factor for isthmicocervical insufficiency.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 5: 5-13 (in Russian)
https://dx.doi.org/10.18565/aig.2022.5.5-13

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