Modern concepts on the etiology and pathogenesis of premature rupture of membranes

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Abstract

Preterm birth is one of the great obstetrical syndromes that poses an enormous problem for obstetricians nowadays. Being the leading cause of infant mortality in the world, it accounts for 80% of all cases of neonatal morbidity and leads to serious financial and emotional losses for families and society. One of the most severe complications leading to preterm birth is premature rupture of membranes (PROM). The article covers the etiological and pathogenetic aspects of PROM including inflammation as a key factor. Aseptic inflammation associated with biological aging and maturation of the membranes is considered as a variant of the PROM pathogenesis. Collagen remodeling, development of microcracks in the membranes, and enhanced angiogenesis are considered as factors contributing to the destruction of the extracellular matrix. To date, the study of rupture of the membranes has been carried out in terms of cell biology and histology, as well as inflammation. This review examines various pathogenetic variants of PROM which may occur independently or in combination. Despite the large number of studies on the subject, there is currently a great interest in new approaches to the prevention of PROM, the search for prognostic markers and risk factors for the development of effective therapeutic tactics.

Conclusion: The introduction of new research methods that can reveal or clarify the mechanisms of aseptic and infectious pathogenesis using mass spectrometry in PROM will help to identify differential patterns of protein expression associated with oxidative stress and bacterial invasion in the amniotic fluid and membranes. The introduction of non-invasive markers into clinical practice will provide the clinicians with the possibility of taking timely preventive measures, prescribing therapy and determining the tactics of management of pregnant women in order to improve the perinatal outcomes.

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About the authors

Almira R. Baisova

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Author for correspondence.
Email: almira.baisova@mail.ru
ORCID iD: 0009-0004-4546-2388

postgraduate student

Russian Federation, Moscow

Elrad Yu. Amiraslanov

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: eldis@mail.ru
ORCID iD: 0000-0001-5601-1241

PhD, Head of the Department of Obstetrics

Russian Federation, Moscow

Vladimir E. Frankevich

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: v_frankevich@oparina4.ru
ORCID iD: 0000-0002-9780-4579

Dr. Sci. (Physico-Mathematical Sciences), Head of the Department of Systems Biology in Reproduction

Russian Federation, Moscow

Vitaliy V. Chagovets

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: v_chagovets@oparina4.ru
ORCID iD: 0000-0002-5120-376X

PhD, Head of the Laboratory of Metabolomics and Bioinformatics

Russian Federation, Moscow

Victor L. Tyutyunnik

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: tioutiounnik@mail.ru
ORCID iD: 0000-0002-5830-5099
SPIN-code: 1963-1359
Scopus Author ID: 56190621500
ResearcherId: B-2364-2015

Professor, Dr. Med. Sci., Leading Researcher of the Center for Scientific and Clinical Research

Russian Federation, Moscow

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