actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.29413/ABS.2022-7.3.3actabiomedica-3541Research ArticleАКУШЕРСТВО И ГИНЕКОЛОГИЯOBSTETRICS AND GYNAECOLOGYРоль акушерского пессария и микронизированного прогестерона в снижении частоты ранних преждевременных родов у беременных с многоплодиемThe role of obstetric pessary and micronized progesteron in early preterm birth prevention in patients with multiple pregnancyhttps://orcid.org/0000-0002-1038-3661БелининаА. А.BelininaA. A.

 кандидат медицинских наук, заместитель главного врача

 656045, г. Барнаул, ул. Фомина, 154, Россия 

 Cand. Sc. (Med.), Deputy Head Physician

Fomina str. 154, Barnaul 656045, Russian Federation  

antonina_belinina@mail.ruhttps://orcid.org/0000-0002-0357-7097БариновС. В.BarinovS. V.

 доктор медицинских наук, профессор, заведующий кафедрой акушерства и гинекологии № 2

 644099, г. Омск, ул. Ленина, 12, Россия 

 Dr. Sc. (Med.), Professor, Head of the Department of Obstetrics and Gynecology No. 2

 Lenina str. 12, Omsk 644099, Russian Federation 

barinov_omsk@mail.ruhttps://orcid.org/0000-0002-0348-5985КадцинаТ. В.KadtsynaT. V.

 доктор медицинских наук, доцент кафедры акушерства и гинекологии № 2

 644099, г. Омск, ул. Ленина, 12, Россия 

 Dr. Sc. (Med.), Associate Professor at the Department of Obstetrics and Gynecology No. 2

 Lenina str. 12, Omsk 644099, Russian Federation 

tatianavlad@list.ruhttps://orcid.org/0000-0002-5812-4925КолядоО. В.KolyadoO. V.

 заведующая отделением, КГБУЗ «Алтайский краевой клинический перинатальный центр»

 656045, г. Барнаул, ул. Фомина, 154, Россия 

 Head of the Department

Fomina str. 154, Barnaul 656045, Russian Federation 

kolyado.ov@gmail.comhttps://orcid.org/0000-0002-0741-8974МолчановаИ. В.MolchanovaI. V.

 кандидат медицинских наук, главный врач, КГБУЗ «Алтайский краевой клинический перинатальный центр»

 656045, г. Барнаул, ул. Фомина, 154, Россия 

 Cand. Sc. (Med.), Head Physician 

 Fomina str. 154, Barnaul 656045, Russian Federation 

molcanova2008@yandex.ruКГБУЗ «Алтайский краевой клинический перинатальный центр»Altay State Clinical Perinatal CentreФГБОУ ВО «Омский государственный медицинский университет» Минздрава РоссииOmsk State Medical University202207072022732229Copyright © Белинина А.А., Баринов С.В., Кадцина Т.В., Колядо О.В., Молчанова И.В., 20222022Белинина А.А., Баринов С.В., Кадцина Т.В., Колядо О.В., Молчанова И.В.Belinina A.A., Barinov S.V., Kadtsyna T.V., Kolyado O.V., Molchanova I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/3541

Обоснование. Многоплодная беременность – повсеместно доказанный фактор риска преждевременных родов. Профилактика досрочного завершения беременности – приоритетная проблема акушерской практики.Цель исследования. Оценить роль акушерского пессария и микронизированного прогестерона в профилактике ранних преждевременных родов у пациенток с многоплодной беременностью.Материалы и методы. Проведено проспективное контролируемое исследование c включением 146 беременных с многоплодной беременностью, которые в зависимости от методов лечения были разделены на 3 группы: группа I (n = 67) – беременные, которые получали микронизированный прогестерон в комплексе с акушерским пессарием. В группу II (n = 57) включили женщин, которые получали микронизированный прогестерон. Группу III (n = 22) составили пациентки с многоплодной беременностью без терапии.Результаты. В группе I комплекс акушерского пессария и микронизированного прогестерона позволил снизить частоту преждевременных родов в 2,3 раза (р = 0,008) в сравнении с группой III, частоту родов в гестационном сроке ≤ 34 недель – в 8,1 раза (р = 0,005) в сравнении с группой III и в 2,7 раза (р < 0,01) в сравнении с группой II. У 70,4 % беременных применение комплекса акушерского пессария с микронизированным прогестероном позволило предотвратить формирование истмико-цервикальной недостаточности, что, по данным сонографии, выражалось в динамике маточно-цервикального угла в сторону более тупого.Заключение. Применение акушерского пессария с микронизированным прогестероном позволило снизить риски истмико-цервикальной недостаточности на 7,7 % по сравнению с пациентками, получавшими терапию только микронизированным прогестероном, и на 17,1 % по сравнению с беременными, не получавшими терапии.

Background. Multiple pregnancy is a well-established risk factor for preterm birth. Prevention of early termination of pregnancy is a priority problem in obstetric practice.The aim. To evaluate the role of an obstetric pessary and micronized progesterone in the prevention of early preterm labor in patients with multiple pregnancies.Materials and methods. A prospective controlled study was conducted with the inclusion of 146 pregnant women with multiple pregnancies, which, depending on the methods of treatment, were divided into three groups: Group I (n = 67) – pregnant women who received micronized progesterone in combination with an obstetric pessary; Group II (n = 57) included women who received micronized progesterone; Group III (n = 22) consisted of patients with multiple pregnancies without therapy.Results. In Group I, the complex of an obstetric pessary and micronized progesterone allowed to reduce the frequency of preterm birth by 2.3 times (p = 0.008) in comparison with Group III, the frequency of births at gestational age ≤ 34 weeks – by 8.1 times (p = 0.005) in compared with Group III and 2.7 times (p < 0.01) compared with Group II. In 70.4 % of pregnant women, the use of a complex of an obstetric pessary with micronized progesterone made it possible to prevent the formation of isthmiccervical insufficiency, which, according to sonography, was expressed in the dynamics of the utero-cervical angle towards a more obtuse one.Conclusion. The use of an obstetric pessary with micronized progesterone made it possible to reduce the risks of isthmic-cervical insufficiency by 7.7 % compared with patients who received only micronized progesterone therapy, and by 17.1 % compared with pregnant women who did not receive therapy.

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The authors declare that there are no conflicts of interest present.