Russian Journal of Woman and Child Health
ISSN 2618-8430 (Print), 2686-7184 (Online)

Incompetent cervix: state-of-the-art

VAK

Scopus

E-libraryDOAJ

russian citation indexroad

ebscoULRICHS

cyberleninkagoogle-scholar

ВИНИТИРГБ

Open accessCrossrefAntiplagiat

RMJ.ru

License Creative Commons
All papers are licensed under a Creative Commons «Attribution» 4.0 License.


Impact factor - 1,090*

* Impact factor according to the SCIENCE INDEX 2022

DOI: 10.32364/2618-8430-2019-2-4-286-291

O.V. Kuznetsova1, E.V. Zarubeeva2

1Pirogov Russian National Research Medical University, Moscow, Russian Federation

2N.V. Sklifosovsky Research Institute of First Aid, Moscow, Russian Federation

This article provides a systematic analysis of published data on incompetent cervix and its role in miscarriage and premature birth and addresses novel pathogenetically oriented management algorithms for this condition. The paper discusses foreign and domestic articles published over the previous two decades. Potential risk factors for incompetent cervix and its role in miscarriage and premature birth are described. Considering that incompetent cervix should be addressed immediately to prevent premature birth being required to select management strategy (surgery or conservative approach), current modalities for early diagnosis and treatment depending on incompetent cervix pathogenesis and obstetrical scenario are compared. Every study in this branch of obstetrics should be considered as a step to overcome this complication of pregnancy as well as to reduce the rate of miscarriage and premature birth.

Keywords: incompetent cervix, cervical cerclage, obstetrical pes sary, micronized progesterone, miscarriage, premature birth.

For citation: Kuznetsova O.V., Zarubeeva E.V. Incompetent cervix: state-of-the-art. Russian Journal of Woman and Child Health. 2019;2(4):286–291.



About the author:

1Olga V. Kuznetsova — MD, PhD, Associate Professor of the Department of Obstetrics and Gynecology, ORCID iD 0000-0003-0842-859X;

2Ekaterina V. Zarubeeva - MD, resident, ORCID iD 0000-0002-5778-8762. 

1Pirogov Russian National Research Medical University. 1, Ostrovityanov str., Moscow, 117437, Russian Federation.

2N.V. Sklifosovsky Research Institute of First Aid. 3/9, B. Sukharevskaya square, Moscow, 129090, Russian Federation.

Contact information: Olga V. Kuznetsova, e-mail: doctor_olja1973@mail.ru.

Financial Disclosure: author has no a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 14.08.2019. 





References
1. Obstetrics. National leadership. Ed. Savelyeva G.M., Sukhikh G.T., Serova V.N., Radzinsky V.E. M.: GEOTAR-Media; 2015 (in Russ.).
2. Clinical recommendations. Obstetrics and gynecology (special issue). Ed. Adamyan L.V., Serova V.N., Sukhikh G.T., Filippova O.S. M.: Media Sphere; 2018 (in Russ.).
3. Sidelnikova V.М. Habitual miscarriage of pregnancy. M.: Triad-X; 2002 (in Russ.).
4. Linchenko N.A. Tactics of Patient Management with Isthmiko-Cervical Insufficiency. Vestnik VolGMU. 2015;1(53):15–18 (in Russ.).
5. Kulakov V.I., Serov V.N., Sidelnikova V.М. Premature birth — tactics of reference with regard to the timing of gestation. Zhurnal akusherstva i zhenskikh bolezney. 2002;2:13–18 (in Russ.).
6. Boyko E.L., Posiseeva L.V., Malyshkina A.I. Rehabilitation of couples with miscarriage of early pregnancy in the anamnesis. Meditsinskiy sovet. Akusherstvo i ginekologiya. 2014;9:17–22 (in Russ.).
7. Dobrokhotova Yu.E., Dzhokhadze L.S., Kopylova Yu.V. Opportunities of therapy of the threat of premature delivery. Ginekologiya. 2016;1:68–70 (in Russ.).
8. Chernyaeva V.I., Neudakhina I.O., Zarechneva T.A. Features of the course of pregnancy and outcomes of labor in case of ischemic-cervical insufficiency. Fundamental’naya i klinicheskaya meditsina. 2016:1(2):70–75 (in Russ.). DOI: 10.23946/2500-0764-2016-1-2-70-75.
9. Gurbanova S.R. Possibilities of optimization of obstetric tactics of conducting pregnancy and childbirth in patients with Isthmiko-cervical insufficiency P markers of undifferentiated connective tissue dysplasia. Vestnik RUDN, seriya: Meditsina. 2009;6:196–200 (in Russ.).
10. Magnesium metabolism and the therapeutic value of its drugs. Manual for physicians. M.: Medpraktika-M; 2004 (in Russ.).
11. Sidelnikova V.M. Prevention and treatment of threatening premature delivery. Akusherstvo i ginekologiya. 2008;3:43–48 (in Russ.).
12. Makarov O.V., Bakhareva I.V., Kuznetsov P.A., Romanovskaya V.V. Modern Approaches to the Prediction of Premature Births. Rossiyskiy vestnik akushera-ginekologa. 2007;7(6):10–15 (in Russ.).
13. Medvedev M.V. Fundamentals of ultrasound screening in the 18–21 week of pregnancy. М.: Real Time; 2015 (in Russ.).
14. Berghella V., Figueroa D., Szychowski J.M. et al. 17-alpha-hydroxyprogesterone caproate for the prevention of preterm birth in women with prior preterm birth and a short cervical length. Am J Obstet Gynecol. 2010;202(4):351.e1–6. DOI: 10.1016/j.ajog.2010.02.019.
15. Rafael T.J., Mackeen A.D., Berghella V. The effect of 17a-hydroxyprogesterone caproate on preterm birth in women with an ultrasound-indicated cerclage. Am J Perinatol. 2011;28:389. DOI: 10.1055/s-0031-1272967.
16. Belotserkovtseva L.D., Kovalenko L.V., Ivannikov S.E., Mirzoeva G.T. Possibilities of early diagnosis of cervical insufficiency for the prevention of premature premature births. Vestnik Novgorodskogo gosudarstvennogo universiteta im. Yaroslava Mudrogo. 2015;2(85):117–123 (in Russ.).
17. Levakov S.A., Borovkova E.I., Sheshukova N.A., Borovkov I.M. Management of patients with ischemic-cervical insufficiency. Akusherstvo, ginekologiya i reproduktsiya. 2016;2:64–69 (in Russ.). DOI:0.17749/2313–47.2016.10.2.064–069].
18. Crane J.M.G., Hutchens D. Transvaginal sonographic measurement of cervical length to predict preterm birth in asymptomatic women at increased risk: a systematic review. Ultrasound Obstet Gynecol. 2008;31:579–587. DOI: 10.1002/uog.5323.
19. Habitual loss of pregnancy: a teaching method. Ed. Belotserkovtseva L.D., Kasparova A.E., Kovalenko L.V. Surgut: IC of Surgu; 2014 (in Russ.).
20. Conde-Agudelo A., Romero R., Nicolaides K. et al. Vaginal progesterone vs. cervical cerclage for the prevention of preterm birth in women with a sonographic short cervix, previous preterm birth, and singleton gestation: a systematic review and indirect comparison metaanalysis. Am J Obstet Gynecol. 208(1):42.e1–42.e18. DOI: 10.1016/j.ajog.2012.10.877.
21. Ehsanipoor R.M., Seligman N.S., Saccone G. et al. Physical Examination-Indicated Cerclage: A Systematic Review and Meta-analysis. Obstet Gynecol. 2015;126:125. DOI: 10.1097/AOG.0000000000000850.
22. Alfirevic Z., Owen J., Carreras Moratonas E. et al. Vaginal progesterone, cerclage or cervical pessary for preventing preterm birth in asymptomatic singleton pregnant women with a history of preterm birth and a sonographic short cervix. Ultrasoung Obstet Gynecol. 2013;41(2):146–151. DOI: 10.1002/uog.12300.
23. Levin I., Salzer L., Maslovitz S. et al. Outcomes of Mid-Trimester Emergency Cerclage in Twin Pregnancies. Fetal Diagn Ther. 2012;32(4):246–250. DOI: 10.1159/000338734.
24. Kokh L.I., Nazarenko L.P., Tsukanova Zh.V., Satysheva I.V. Dysplasia of connective tissue as one of the possible causes of ischemic-cervical insufficiency. Zhurnal akusherstva i zhenskikh bolezney. 2010;58(3):45–49 (in Russ.).
25. Filipрova N.A. The Role of Algorithm of Ultrasonic Monitoring in the Optimization of the Results of Multiple Pregnancy. Sibirskiy meditsinskiy zhurnal. 2009;2:99–103 (in Russ.).
26. Bespalova O.N., Sargsyan G.S. Obstetrical pessaries in clinical practice. Zhurnal akusherstva i zhenskikh bolezney. 2015;64(2):97–107 (in Russ.). DOI: 10.17816/JOWD64297-107.
27. Goya M., Pratcorona L., Merced C. et al. Cervical pessary in pregnant women with a short cervix (PECEP): an openlabel randomized controlled trial. Lancet. 2012;379:1800–1806. DOI: 10.1016/S0140-6736(12)60030-0.
28. Nazarenko T.A. Gestagens in the practice of an obstetrician-gynecologist. (Electronic resource). URL: https://openmedcom.ru/lections/469. Access date: 12.07.2019 (in Russ.).
29. Genazzani A.R., Szekeres-Bartho J., El-Zibdeh M.Y. Maintenance of a successful pregnancy: the role of the drug Dyufaston. Mezhdunarodnyy Byulleten’: Akusherstvo i Ginekologiya. 2003;1:1–6 (in Russ.).
30. Voevodin D.A. Cytokine-hormonal interactions: the situation of the immunoendocrine regulatory system. Pediatriya. 2006;1:95–102 (in Russ.).
31. Egorova T.A., Bazina M.I. Experience in the application of morning care with threatening premature birth. Rossiyskiy vestnik akushera-ginekologa. 2004;4(4):58–60 (in Russ.).
32. Dobrokhotova Yu.E. Utrozestan in the treatment of miscarriage. M., 2005 (in Russ.).
33. Kokh L.I., Satysheva I.V. Diagnostics and results of treatment of isthmic-cervical insufficiency. Akusherstvo i ginekologiya. 2011;7(2):29–32 (in Russ.).
34. Savelyeva G.M., Shalin R.I., Kurtser M.A. et al. Premature birth, as the most important problem of modern obstetrics. Akusherstvo i ginekologiya. 2012;8–2:4–10 (in Russ.).
35. Sidelnikova V.M. Premature birth. M.; 2006 (in Russ.).
36. Pustotina O.A. Justification for the use of morning dress in the second half of pregnancy. Trudnyy patsiyent. 2005;3(9):14–17 (in Russ.).
37. Тalalayev V.Yu., Lomunova MA, Zaichenko I.E. The effect of cytotrophoblast cell sonmaturation and the function of T-lymphocytes producing cytokines. Immunologiya. 2006;27(2):68–73 (in Russ.).
38. Prevention of miscarriage and premature birth in the modern world. Resolution of the Expert Council within the framework of the 16th World Congress on Human Reproduction (Berlin, March 18–21, 2015). Information mail. M.: Editorial staff of the magazine Status Praesens; 2015 (in Russ.).
39. Dobrokhotova Yu.S., Stepanyan A.V., Shustova V.B., Dikke G.B. Isthmiko-cervical insufficiency: modern basic therapy. Farmateka. 2015;3:38–43 (in Russ.).
40. Dobrokotova Yu.E., Kuznetsova O.V., Mezentseva L.E., Popova L.V. Magnesium preparations in the complex treatment of miscarriages. RMJ. 2017;2:116–120 (in Russ.).
41. Dobrokhotova Yu.S., Stepanyan A.V., Shustova V.B., Dicke G.B. Isthmiko-cervical insufficiency: modern basic therapy. Pharmateka. 2015;3:38–43 (in Russ.).
42. The clinical protocol “Premature birth”. M.; 2013 (in Russ.).
43. Order of the Ministry of Health of Russia from 01.11.2012 N 572n (Edited on January 17, 2014) “On approval of the order of medical care in the field of obstetrics and gynecology (excluding the use of assisted reproductive technologies)” (registered in the Ministry of Justice of Russia on 02.04.2013 N 27960) (in Russ.).
44. Tetruashvili N.K., Agadzhanova A.A., Milusheva A.K. Correction of ischemic-cervical insufficiency during prolapse of the fetal bladder: the possibility of therapy. Akusherstvo i ginekologiya. 2015;9:106–109 (in Russ.).
45. Serov V.N., Sukhorukova O.I. Premature birth — diagnosis and therapy. Meditsinskiy sovet. Akusherstvo i ginekologiya. 2014;9:50–54 (in Russ.).
46. Posiseeva L.V., Kriventseva T.A., Sotnikova N.Yu. et al. Immunocytotherapy in pregravity training of women with miscarriage of early pregnancy and antiphospholipid syndrome. Obstetrics and Gynecology. 2010;3:21–24 (in Russ.).



License Creative Commons
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Previous paper
Next paper

Register now and get access to useful services:
  • Загрузка полнотекстовых версий журналов (PDF)
  • Медицинские калькуляторы
  • Список избранных статей по Вашей специальности
  • Видеоконференции и многое другое

С нами уже 50 000 врачей из различных областей.
Присоединяйтесь!
[Error] 
Call to undefined function get_registration_form_description_popup() (0)
/home/c/cb72209/wchjournal/public_html/en/include/reg_form.php:89
#0: include
	/home/c/cb72209/wchjournal/public_html/bitrix/modules/main/classes/general/main.php:1419
#1: CAllMain->IncludeFile(string)
	/home/c/cb72209/wchjournal/public_html/local/templates/.default/include/cl-footer.php:217
#2: include_once(string)
	/home/c/cb72209/wchjournal/public_html/local/templates/cl_inner_sidebar_en/footer.php:11
#3: include_once(string)
	/home/c/cb72209/wchjournal/public_html/bitrix/modules/main/include/epilog_before.php:93
#4: require(string)
	/home/c/cb72209/wchjournal/public_html/bitrix/modules/main/include/epilog.php:2
#5: require_once(string)
	/home/c/cb72209/wchjournal/public_html/bitrix/footer.php:4
#6: require(string)
	/home/c/cb72209/wchjournal/public_html/en/articles/index.php:150
#7: include_once(string)
	/home/c/cb72209/wchjournal/public_html/bitrix/modules/main/include/urlrewrite.php:184
#8: include_once(string)
	/home/c/cb72209/wchjournal/public_html/bitrix/urlrewrite.php:2
----------