Modern studies of the effectiveness and safety of methods for the prevention of preterm birth

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Abstract

The problem of saving every desired pregnancy is relevant in our country due to the difficult demographic situation. Preterm morta-lity rates remain high. Data from studies on the prevention of preterm birth (PB) by administration of progesterone to women with risk factors (history of PB, short cervix, multiple pregnancies) are heterogeneous. Vaginal administration of micronized progesterone is preferred. Cerclage has shown an effect only in singleton pregnancies with previous spontaneous PB in combination with a short cervix. There is no evidence for prophylactic cerclage in multiple pregnancies, even in cases of short cervix. An emergency cerclage remains an indication after an individual consultation. The effect of the cervical pessary in singleton and multiple pregnancies in patients at risk of preterm birth appears to be promising compared to other secondary prevention options when therapy is initiated at the early stages of precocious cervical ripening. Approaches related to nutrition and the intake of dietary supplements for the prevention of PB (zinc, vitamin D, docosahexaenoic acid) are promising/ Smoking cessation before pregnancy is an effective measure to prevent PB. Conclusion. Decisions in favor of choosing one or another method of prevention of PB should be made individually in each case.

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About the authors

Natalia A. Gabitova

Federal Research and Clinical Center for Specialized Types of Medical Care and Medical Technologies of FMBA

Author for correspondence.
Email: gabitova_nataliya@mail.ru
ORCID iD: 0000-0003-2278-2624
SPIN-code: 4812-3600

Dr. Sci (Med.), Professor, Department of Obstetrics and Gynecology, Academy of Postgraduate Education

Russian Federation, Moscow

A. G. Kedrova

Federal Research and Clinical Center for Specialized Types of Medical Care and Medical Technologies of FMBA

Email: gabitova_nataliya@mail.ru
ORCID iD: 0000-0003-1031-9376
Russian Federation, Moscow

G. B. Dikke

Academy of Medical Education n.a. F.I. Inozemtsev

Email: gabitova_nataliya@mail.ru
ORCID iD: 0000-0001-9524-8962
Russian Federation, St. Petersburg

T. N. Belousova

Vidnoye Perinatal Center

Email: gabitova_nataliya@mail.ru
ORCID iD: 0000-0003-3804-7691
Russian Federation, Vidnoe, Moscow region

O. G. Malysheva

Federal Research and Clinical Center for Specialized Types of Medical Care and Medical Technologies of FMBA

Email: gabitova_nataliya@mail.ru
ORCID iD: 0009-0009-6089-7589
Russian Federation, Moscow

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