PROGESTINS FOR THE PREVENTION OF PRETERM BIRTH IN WOMEN WITH ITS HISTORY

Objective. To reduce preterm birth rates in patients with its history and to evaluate the efficacy and safety of Pragisan in preventing preterm birth. Subjects and methods. The investigation enrolled 30patients who had a history of preterm birth at 24-33 weeks’ gestation and were followed up at the Scientific Polyclinic of the Research Institute of Maternal and Infant Care, Ministry of Health of Russia, in 2014-2015. At their inclusion in the investigation, the patients underwent ultrasonography, the goal of which was to establish the presence of a live fetus, the absence of fetal congenital malformations, decompensated placental insufficiency, as well as to record the signs of threatened miscarriage during transvaginal cervicometry. If the cervix was shorter than 35 mm, Pragisan was used as prevention in the regimen: 100 mg thrice daily intravaginally for the first 4 days, 100 mg twice daily on day 5 until 33 weeks’ gestation. Ultrasound cervicometry was carried out and intrauterine fetal growth rates were estimated during the follow-up. Results. Severe extragenital and gynecological diseases and hypersensitivity to the drug and its components were not recorded in the patients. All the patients were noted to have cervical shortening less than 35 mm. The minimal length of the cervix uteri was 21 mm. Among the 30 enrolled in the investigation, there were 13, 5, and 12 patients at 16, 20, and 24-25 weeks’ gestation, respectively. An obstetric unloading pessary should be placed in 2 cases. Based on the findings, the authors proposed an algorithm for prevention ofpreterm birth in patients with its history. Conclusion. Incorporation of Pragisan into a package of measures to prevent preterm birth in women with its history and signs of threatened miscarriage, as evidenced by cervicometry, allows the proportion of recurrent preterm birth to be reduced.

perinatology, preterm birth, progesterone