PREDICTION OF PREMATURE LABOR IN WOMEN WITH A HISTORY OF PRIMARY AND SECONDARY MISCARRIAGE

Objective. To study factors influencing premature delivery in women with a history of recurrent miscarriage (RM) and varying reproductive onset and to evaluate their infants’ health status in the course of an early neonatal period. Subjects and methods. Medical histories, the specific features of reproductive function, the course of pregnancy, labor, placental histology, and neonatal health status were analyzed in 266 women with a history of RM, who gave birth at the Research Institute of Maternal and Infant Care in 2004—2009. During the study, according to the principle of reproductive onset, the women were divided into 2 groups: those with primary and secondary RM (PRM and SRM). Results. Based on the f indings, the authors revealed predictors of preterm birth for each group. These for PRM were chronic intrauterine infection, markers of undifferentiated maternal connective tissue dysplasia, severe preeclampsia, fetal growth retardation syndrome and missed abortion in the history. These for SRM were preterm birth in the history, placental insufficiency, severe preeclampsia, placenta previa in the examined pregnancy, and patient cardiovascular diseases. Conclusion. Incorporation of dydrogesterone into the combination therapy for threatened miscarriage in women with RM can reduce the rate of its persistent risk and has a protective effect on the determinants of preterm delivery in the patients of these groups and on the early neonatal adaptation of their newborn infants.

recurrent fetal loss, perinatology, preterm birth