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3. Приложение . 2019

Progesteron: disputable issues of therapy and prevention of prematurity and preterm birth

Abstract

In the article etiopathogenesis of such important problems for obstetrics and gynecology as miscarriage, recurrent miscarriage and premature birth is considered. The role of progesterone in the processes of conception, successful carrying of a pregnancy and its resolution is described in detail. The basis of these pathological conditions prediction and treatment which is confirmed by recent clinical trials data is given.

Keywords:miscarriage, recurrent miscarriage, premature birth, prediction, prevention, therapy, progesterone preparations, progesterone

For citation: Radzinskiy V.E., Khamoshina M.B., Tulupova M.S., Damirova K.F., Ramazanova F.U., Kaushanskaya L.V. Progesteron: disputable issues of therapy and prevention of prematurity and preterm birth. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2019; 7 (3). Supplement: 74-82. doi: 10.24411/2303-9698-2019-13910 (in Russian)

References

1. Howard J.A. Carp. Habitual miscarriage. Causes. Versions and con-traverses. Treatment. Edit. by V.E. Radzinskiy. Moscow: GEOTAR-Media, 2017. Р. 22-23. (in Russian)

2. Rysavy M.A., Li L., Bell E.F., Das A., Hintz Sr., Stoll B.J., Vohr B.R., et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. B etween-hospital variation in treatment and outcomes in extremely preterm infants. New Engl J Med. 2015; 372: 1801-11.

3. Park J.Y., Jung Y.M., Kook S.-Y., Jeon S.J., Oh K.J., Hong J.-S. The effect of postoperative vaginal progesterone in ultrasound-indicated cerclage to prevent preterm birth. J Matern Fetal Neonatal Med. 2019. Sept. 26: 1-8. [Epub ahead of print].

4. Saccone G., Ciardulli A., Xodo S., Dugoff L., Ludmir J., Pagani G. et al. Cervical pessary for preventing preterm birth in singleton pregnancies with short cervical length: a systematic review and meta-analysis. J. Ultrasound Med. 2017; 36 (8): 1535-43.

5. Saccone G., Ciardulli A., Xodo S., Dugoff L., Ludmir J., D'Antonio F. et al. Cervical pessary for preventing preterm birth in twin pregnancies with short cervical length: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2017. Jan 12: 1-8.

6. Barinov S.V., Artymuk N.V., Novikova O.N., Shamina I.V., Tirskaya Y.I., Belinina A.A. et al. Analysis of risk factors and predictors of pregnancy loss and strategies for the management of cervical insufficiency in pregnant women at a high risk of preterm birth. J Matern Fetal Neonatal Med. 2019. Sept. 3: 1-9. doi: 10.1080/14767058.2019.1656195.

7. Berghella V., Odibo A.O., To M.S., Rust O.A., Althuisius S.M. Cerclage for short cervix on ultrasonography: meta-analysis of trials using individual patient-level data. Obstet Gynecol. 2005; 106: 181-9.

8. Saccone G., Perriera L., Berghella V. Prior uterine evacuation of pregnancy as independent risk factor for preterm birth: a systematic review and metaanalysis. Am J Obstet Gynecol. 2016; 214 (5): 572-91.

9. Berghella V., Rafael T.J., Szychowski J.M., Rust O.A., Owen J. Cerclage for short cervix on ultrasonography in women with singleton gestations and previous preterm birth: a meta-analysis. Obstet Gynecol. 2011; 117: 663-71.

10. 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. 2013; 208: 42.e1-42.e18.

11. Conde-Agudelo A., Romero R., Da Fonseca E., O'Brien J.M., Cet-ingoz E., Creasy G.W., et al. Vaginal progesterone is as effective as cervical cerclage to prevent preterm birth in women with a singleton gestation, previous spontaneous preterm birth, and a short cervix: updated indirect comparison meta-analysis. Am J Obstet Gynecol. 2018; 219 (1): 10-25. doi: 10.1016/j.ajog.2018.03.028.

12. Romero R., Nicolaides K.H., Conde-Agudelo A., O'Brien J.M., Cet-ingoz E., Da Fonseca E. et al. (2016). Vaginal progesterone decreases preterm birth < 34 weeks of gestation in women with a singleton pregnancy and a short cervix: an updated meta-analysis including data from the OPPTIMUM study. Ultrasound Obstet Gynecol. 2016; 48 (3): 308-17.

13. Atlasov V.O. Features of delivery and the condition of newborns in women after in vitro fertilization. http://www.critical.ru/conftexts/2005/ akusherstvo/art10_ak_2005.htm. (in Russian)

14. Schumacher M., Mattern C. Revisiting the roles of progesterone and allopregnanolone in the nervous system: Resurgence of the progesterone receptor. Prog Neurobiol. 2014; 113: 6-39.

15. Macklon N.S., Geraedts J.P., Fauser B.C.Conception to ongoing pregnancy: the ‘black box' of early pregnancy loss. Hum Reprod Update. 2002; 8 (4): 333-43.

16. Instructions for the drug Utrozhestan. (in Russian)

17. Shimanovsky N.L., Kareva E.N. Molecular mechanisms of gestagen action. Eksperimental'naya i klinicheskaya farmakologiya [Experimental and Clinical Pharmacology]. 2011; 4: 36-42. (in Russian)

18. Thomas P. Characteristics of membrane progestin receptor alpha (mPRalpha) and progesterone membrane receptor component 1 (PGMRC1) and their roles in mediating rapid progestin actions. Front Neuroendocrinol. 2008; 29 (2): 292-312. doi: 10.1016/j.yfrne.2008.01.001.

19. Thomas P., Pang Y., Dong J. Enhancement of cell surface expression and receptor functions of membrane progestin receptor a (mPRa) by progesterone receptor membrane component 1 (PGRMC1): evidence for a role of PGRMC1 as an adaptor protein for steroid receptors. Endocrinology. 2014; 155 (3): 1107-19. doi: 10.1210/en.2013-1991.

20. Miscarriage in early pregnancy: diagnosis and tactics reference. Clinical recommendations (treatment protocol). Moscow, 2016. (in Russian)

21. Age-specific fertility rates. Healthcare in Russia 2017. Moscow: Rosstat, 2017. 170 p. (in Russian)

22. Stephenson M.D., et al. Luteal start vaginal micronized progesterone improves pregnancy success in women with recurrent pregnancy loss. Fertil Steril. 2016; 107 (Iss. 3): 684-90.

23. Aganezov S.S., Aganezova N.V., Morotskaya A.V., Ponomarenko K.Yu. Endometrial receptivity in women with impaired reproductive function. Journal of Obstetrics and Women's Diseases. 2017; 66 (3): 135-142. (in Russian)

24. Qu X., Yang M., Zhang W., Liang L., Yang Y., Zhang Y., et al. Os-teopontin expression in human decidua is associated with decidual natural killer cells recruitment and regulated by progesterone. In Vivo. 2008; 22: 55-61.

25. Davidson L.M., Coward K. Molecular mechanisms of membrane interaction at implantation Birth defect research Part C. Embryo Today. 2016; 108 (1): 19-32. doi: 10.1002/bdrc.21122.

26. Achache H., Revel A. Endometrial receptivity markers, the journey to successful embryo implantation. Hum Reprod Update. 2006; 12 (6): 731-46.

27. Li Q., Wang J., Armant D.R., et al. Calcitonin down-regulates E-cad-herin expression in rodent uterine epithelium during implantation. J Biol Chem. 2002; 277: 46447-55.

28. Liu X., Zhang D., Wang T., et al. Ion/water channels for embryo implantation barrier. Physiology. 2014; 29: 186-96. doi: 10.1152/physiol.00039.2013.

29. Nobuzane T., Tashiro S., Kudo Y. Morphologic effects of epithelial ion channels on the mouse uterus: differences between raloxifene analog (LY117018) and estradiol treatments. Am J Obstet Gynecol. 2008; 199: 363. doi: 10.1016/j.ajog.2008.03.047.

30. Monastra G., De Grazia S., De Luca L., Vittorio S., Unfer V. Vitamin D: a steroid hormone with progesterone-like activity. Eur Rev Med Pharmacol Sci. 2018; 22 (8): 2502-12. doi: 10.26355/eurrev_201804_14845.

31. Thangamani S., Kim M., Son Y., Huang X., Kim H., Lee J.H., et al. Cutting edge: progesterone directly upregulates vitamin d receptor gene expression for efficient regulation of T cells by calcitriol. J Immunol. 2015; 194: 883-6.

32. Radzinskiy V.E. Obstetric aggression v. 2.0. Moscow: StatusPrae-sens, 2017. 872 p. (in Russian)

33. ESHRE Early Pregnancy Guideline Development Group. Recurrent Pregnancy Loss, 2017.

34. Chotchaeva A.I. Prevention of complicated pregnancy in the second trimester: Autoabstract of Diss. Moscow, 2013. 24 p. (in Russian)

35. Haas D.M., Hathaway T.J., Ramsey P.S. Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology. Cochrane Database of Systematic Reviews 2018, Issue 10. Art. No.: CD003511. doi: 10.1002/14651858.CD003511.pub4.

36. Stephenson M., Kutteh W. Evaluation and management of recurrent early pregnancy loss. Clin Obstet Gynecol. 2007; 50: 132-45.

37. Ismail A.M., Abbas A.M., Ali M.K., Amin A.F. Peri-conceptional progesterone treatment in women with unexplained recurrent miscarriage: a randomized double-blind placebocontrolled trial. J Matern Fetal Neonatal Med. 2018; 31 (3): 388-394. doi: 10.1080/14767058.2017.1286315.

38. Conclusion of the Workshop of the expert group in the framework of the Regional Forum “Mother and Child”. Problemy reproduktsii [Russian Journal of Human Reproduction]. 2017. Vol. 23 (3): 32-4. (in Russian)

39. Clinical protocol on pregravid preparation. Moscow: MARS, 2016. (in Russian)

40. Clinical recommendations. Obstetrics and gynecology. 4th ed. Edit by V.N. Serov, G.T. Sukhikh. Moscow: GEOTAR-Media, 2014. 1024 p. (in Russian)

41. Orazov M.R., Radzinsky V.E., Khamoshina M.B., Kaygorodova L.A., Toktar L.R., Pokul L.V., et al. Secrets of reproductive failures: “thin endometrium”. Reproduktivnaya meditsina [Reproductive Medicine]. 2018; 2 (35). (in Russian)

42. Zamotina I., Khamoshina M., Radzinskiy V., Lebedeva M., Kostin I. Comparative effectiveness of correction of Cervical incompetence through cerclage and obstetric pessary / Congress Program & Abstracts of the 25th World Congress on Controversies in Obstetrics, Gynecology & Infertility (COGI). Vienna, Austria, November 30-December 2, 2017. Р. 118-119.

43. Szekeres-Bartho J., Barakonyi A., Par G., Polgar B., Palkovics T., Szereday L. Progesterone as an immunomodulatory molecule. Int Immuno-pharmacol. 2001; 1 (6): 1037-48.

44. Quinn C., Casper R.F. Pinopodes: a questionable role in endometrial receptivity. J Reprod Immunol. 2009; 39: 117-31.

45. Kareva E.N., Solomatina A.A., Bekhbudova L.Kh., Kotsyubinskaya N.A., Gorenkova O.S., Tikhonov D.A., et al. Molecular mechanisms of action of progesterone in the endometrium. Molekulyarnaya meditsina [Molecular Medicine]. 2016; 14 (3): 9-16. (in Russian)

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CHIEF EDITORS
CHIEF EDITOR
Sukhikh Gennadii Tikhonovich
Academician of the Russian Academy of Medical Sciences, V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Moscow
CHIEF EDITOR
Kurtser Mark Arkadievich
Academician of the Russian Academy of Sciences, MD, Professor, Head of the Obstetrics and Gynecology Subdepartment of the Pediatric Department, N.I. Pirogov Russian National Scientific Research Medical University, Ministry of Health of the Russian Federation
CHIEF EDITOR
Radzinsky Viktor Evseevich
Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of the Subdepartment of Obstetrics and Gynecology with a Course of Perinatology of the Medical Department in the Russian People?s Friendship University

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