Very early premature birth and isthmic-cervical insufficiency in pregnancy resulting from assisted reproductive technologies
Objective. To identify risk factors for very early premature birth (VEPB) and isthmic-cervical insufficiency (ICI) in pregnancy resulting from assisted reproductive technologies (ART).Malgina G.B., Fassakhova A.F., Tretyakova T.B., Brusnitsyna V.Yu., Rykosuev N.E.
Subjects and methods. Step 1 was to retrospectively assess perinatal outcomes in 483 pregnant women after ART and in 645 patients with natural conception. Step 2 was to conduct a case-control study. A study group included 76 pregnant women after ART with ICI: 33 and 43 women had singleton and multiple pregnancies, respectively. A control group consisted of 67 pregnant women after ART with no ICI: 37 and 30 women with singleton and multiple pregnancies, respectively.
Results. Odds ratio (OR) for ICI after ART was 5.5 with 95% CI, 3.6-8.4; p < 0.05. OR for VEPB after ART was 3.3 with 95% CI, 1.4 to 8.1; p< 0.05. ICI in VEPB was detected in 75.6%. The risk factors for ICI after ART are 3 or more attempts of the latter, the lack of long-term hormonal support and cervicometry. In singleton pregnancy, the additional risk factors are a history of early miscarriages, as well as endocrinopathy.
Conclusion. Cervicometry and prolonged progestin support are recommended for the prevention of ICI during pregnancy after ART.
Keywords
assisted reproductive technologies
very early premature birth
isthmic-cervical insufficiency
risk factors
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Received 01.09.2017
Accepted 22.09.2017
About the Authors
Malgina Galina B., Professor, Head of Science of Ural Research Institute of Maternal and Infant Care, Ministry of Health of Russia.620028, Yekaterinburg, Repin str. 1. Tel.: +73433710878. E-mail: galinamalgina@mail.ru. ORCID ID 0000-0002-5500-6296
Fassakhova Aigul F., Junior Researcher, Scientific Department of Antenatal Fetal Care, Ural Research Institute of Maternal and Infant Care, Ministry of Health of Russia. 620028, Yekaterinburg, Repin str. 1. Tel.: +73433710878
Tretyakova Tatyana B., PhD, Senior Researcher, Scientific Department of Biochemistry with Genetics Group, Ural Research Institute of Maternal and Infant Care,
Ministry of Health of Russia. 620028, Yekaterinburg, Repin str. 1. Tel.: +73433710878
BrusnitsinaVera Ju, Senior Researcher, Scientific Department of the Preservation of Reproductive Function, Ural Research Institute of Maternal and Infant Care,
Ministry of Health of Russia. 620028, Yekaterinburg, Repin str. 1. Tel.: +73433710878
Roukosouev Nikita Ye., Junior Researcher, Scientific Department of Biochemistry with Genetics Group, Ural Research Institute of Maternal and Infant Care,
Ministry of Health of Russia. 620028, Yekaterinburg, Repin str. 1. Tel.: +73433710878
For citations: Malgina G.B., Fassakhova A.F., Tretyakova T.B.,
Brusnitsyna V.Yu., Rykosuev N.E. Very early premature birth and isthmic-cervical insufficiency
in pregnancy resulting from assisted reproductive technologies.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (5): 44-9. (in Russian)
https://dx.doi.org/10.18565/aig.2018.5.44-49
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