Connective tissue dysplasia in the genesis of cervical incompetence
Abstract
Aim: to study a role of undifferentiated connective tissue dysplasia (uCTD) in etiology of cervical incompetence and its effect on pregnancy and childbirth course.
Material and Methods. There were enrolled 60 patients with cervical incompetence. Patients were divided into 3 groups according to the modified CTD scale: group 1 - patients without uCTD (n = 21); group 2 - patients with mild uCTD (n = 25); group 3 - patients with moderate-to-severe uCTD (n = 14). Intensity of CTD clinical signs was assessed based on health status, gynecological and obstetric history, the course of pregnancy, labor and the postpartum period.
Results. It was found that patients with more prominent CTD developed earlier (r-Spearman = -0.26) and more marked (r-Spearman = -0.29) cervical shortening and opening of the internal orifice of the uterus (r-Spearman = 0.28). It was also noted that likelihood of occurring preterm labor was significantly higher in patients with CTD (p = 0.02).
Conclusion. The data obtained evidence that uCTD affects intensity of manifested cervical insufficiency and rate of preterm delivery.
About the Authors
E. V. Fotina
Lomonosov Moscow State University
Russian Federation
Russian Federation
Evgenia V. Fotina - MD, Researcher, Medical Research Educational Center, Lomonosov Moscow State University.
27 Lomonosovskiy Ave., Moscow 119192.
R. R. Zakirova
Lomonosov Moscow State University
Russian Federation
Russian Federation
Renata R. Zakirova - 6th year Student, Faculty of Fundamental Medicine, Lomonosov Moscow State University.
27 Lomonosovskiy Ave., Moscow 119192.
M. V. Alekseenkova
Lomonosov Moscow State University
Russian Federation
Russian Federation
Maria V. Alekseenkova - MD, PhD, Assistant, Department of Obstetrics and Gynecology, Faculty of Fundamental Medicine, Lomonosov Moscow State University.
27 Lomonosovskiy Ave., Moscow 119192.
O. B. Panina
Lomonosov Moscow State University
Russian Federation
Russian Federation
Olga B. Panina - MD, Dr Sci Med, Professor, Head of the Department of Obstetrics, Gynecology and Reproductive Medicine, Medical Research Educational Center, Head of the Department of Obstetrics and Gynecology, Faculty of Fundamental Medicine, Lomonosov Moscow State University.
27 Lomonosovskiy Ave., Moscow 119192.
References
1. Lukyanova E.A. Isthmic-cervical insufficiency: a look at the problem. [Istmiko-cervikal'naya nedostatochnost': vzglyad na problem]. Ohrana materinstva i detstva. 2010;(1):73-7. (In Russ.).
2. Radzinsky V.E., Kostin I.S., Olenev A.S. et al. Preterm delivery is an unsettled world problem. [Prezhdevremennye rody - nereshennaya mirovaya problema]. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie. 2018;(53):55-64. (In Russ.). https://doi.org/10.24411/2303-9698-2018-13909.
3. Lee S.E., Romero R., Jung H. et al. The intensity of the fetal inflammatory response in intraamniotic inflammation with and without microbial invasion of the amniotic cavity. Am J Obstet Gynecol. 2007;197(3):294. e1-6. https://doi.org/10.1016/j.ajog.2007.07.006.
4. Ghezzi F., Franchi M., Raio L. et al. Elevated amniotic fluid C-reactive protein at the time of genetic amniocentesis is a marker for preterm delivery. Am J Obstet Gynecol. 2002;186(2):268-73. https://doi.org/10.1067/mob.2002.119628.
5. Lee S.E., Romero R., Park C.W. et al. The frequency and significance of intraamniotic inflammation in patients with cervical insufficiency. Am J Obstet Gynecol. 2008;198(6):633.e1-8. https://doi.org/10.1016/j.ajog.2007.11.047.
6. Kokh L.I., Nazarenko L.P., Tsukanova Zh.V., Satysheva I.V. The significance of connective tissue dysplasia in the development of cervical incompetence. [Znachenie displazii soedinitel'noj tkani v razvitii istmiko-cervikal'noj nedostatochnosti]. Byulleten' sibirskoj mediciny. 2009;(4-2):74-6. (In Russ.).
7. Kan N.E., Amiraslanov E.Yu., Tyutyunnik V.L. A rating scale of undifferentiated connective tissue dysplasia in predicting obstetric complications. [Ball'naya shkala ocenka nedifferencirovannoj displazii soedinitel'noj tkani v prognozirovanii akusherskih oslozhnenij]. Akusherstvo i ginekologiya. 2014;(7):38-42. (In Russ.).
8. Gurbanova S.R. Optimization of obstetric management in women with undifferentiated collagen tissue dysplasia and cervical incompetence. [Vozmozhnosti optimizacii akusherskoj taktiki vedeniya beremennosti i rodov u pacientok s istmiko-cervikal'noj nedostatochnost'yu i markerami nedifferencirovannoj displazii soedinitel'noj tkani]. Vestnik Rossijskogo universiteta druzhby narodov. Seriya: Medicina. 2008;(6):196-200. (In Russ.).
9. Frolov A.L., Kulavsky V.A., Nikiforova M.V. The role of markers of dysplasia connective tissue in development of isthmicocervical insufficiency during the pregnancy. [Rol' markerov displazii soedinitel'noj tkani v razvitii istmiko-cervikal'noj nedostatochnosti pri beremennosti]. Mat' i Ditya v Kuzbasse. 2014;(3):54-6. (In Russ.).
10. Ben Salha M., Repina N.B. Clinical diagnostics of undifferentiated connective tissue dysplasia. [Klinicheskaya diagnostika nedifferencirovannoj displazii soedinitel'noj tkani]. Rossijskij mediko-biologicheskij vestnik imeni akademika I.P. Pavlova. 2016;24(4):164-72. (In Russ.). https://doi.org/10.23888/PAVLOVJ20164164-172.
Supporting agencies: The study was conducted within the framework of the State Assignment by using the equipment purchased in accordance with the Lomonosov Moscow State University scientific development program.
For citation:
Fotina E.V., Zakirova R.R., Alekseenkova M.V., Panina O.B. Connective tissue dysplasia in the genesis of cervical incompetence. Obstetrics, Gynecology and Reproduction. 2021;15(1):41-50. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.131
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