Cervical Insufficiency: Classification, Etiopathogenesis, Diagnosis, Methods of Prophylaxis and Corrections (Clinical Lecture)

Zhabchenko, I.A.; Занько, С. Н.

doi:10.37800/rm2020-1-4

Cited by 4 publications

(6 citation statements)

References 10 publications

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“…It is possible that systemic connective tissue dysplasia plays a leading role in the pathogenesis of ICI development. The pathogenesis of dysplastic changes is based on the pathology of the fibrillar component of connective tissue [1,12,15,19].…”

Section: «Art Of Medicine»mentioning

confidence: 99%

“…Among the biochemical components that play an important role in the functioning of the cervix are proteins such as collagen and elastin, as well as glycoproteins and hydrocarbon components that are actively involved in the differentiation and mutual recognition of cells, intercellular contacts, adhesion, adhesion, and receptors. Changes in the quantitative content of glycoproteins and their carbohydrate components affect the structural and functional characteristics of the cervix [9,13,15,19,22].…”

Section: «Art Of Medicine»mentioning

confidence: 99%

“…It has also been suggested that reduced concentrations of collagen and elastic fibers in cervical tissue lead to ICI. It is believed that these changes in cervical tissue are observed both during and outside pregnancy [15,18,26].…”

Section: «Art Of Medicine»mentioning

confidence: 99%

“…Today, CT dysplasia is understood as a disorder of its development, which is characterized by defects in the basic substance and fiber. Among the main causes of UCTD are changes in the rate of synthesis and construction of collagen and elastin, synthesis of immature collagen, disruption of the structure of collagen and elastin fibers due to their insufficient lumbar crosslinking [7,11,15,19].…”

Section: «Art Of Medicine»mentioning

confidence: 99%

“…Some authors [1,15] found a connection between the development of functional ICI and ICI of combined genesis with undifferentiated connective tissue dysplasia and magnesium deficiency. It is known that the cervix consists of collagen and proteoglycans.…”

Section: «Art Of Medicine»mentioning

confidence: 99%

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Modern Aspects of the Etiopathogenesis of Istmic-Cervical Insufficiency

Levytskyi

Кінаш

2022

Scientific and practical journal

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Isthmic-cervical insufficiency (ICI), which results in the failure of the circular muscles of the internal os, isthmus and cervix of the uterus is important in the pathogenesis of preterm birth. The existing types are anatomical, functional and congenital ICI. ICI is a pathological condition of the cervix and the isthmus, in which they are unable to withstand the intrauterine pressure and keep a fertilized egg in the uterine cavity until birth. ICI is a serious complication of pregnancy. Genetic, hormonal, inflammatory-infectious, immunological, traumatic factors play a role in the occurrence of ICI. The aim of the study is to study the peculiarities of reproductive health and gestational process of pregnant women with ICI, according to the literature. For the study, we analyzed domestic and foreign publications on this topic in professional journals, as well as data from Internet resources. Results of the research show that ICI plays a special role among many causes that lead to preterm termination of pregnancy and premature birth in the II-III trimesters. The properties of the cervix depend on the ratio of connective and muscle tissue. Today, most authors distinguish between congenital, acquired, organic and functional isthmic-cervical insufficiency.Organic (post-traumatic, secondary) ICI occurs due to mechanical damage to the cervix. Functional ICI is the result of a violation of the relationship between the muscular and connective tissues of the cervix, as well as the result of changes in the response of its structural elements to neurohumoral stimuli. Functional ICI most often occurs as a consequence of a violation of the hormonal background of women (ovarian hypofunction, hyperandrogenism). Congenital ICI occurs in malformations of the uterus, genital infantilism. Histological examination of cervical tissue in women with ICI reveals an increase in muscle tissue up to 50%, which leads to early softening of the cervix of the uterus and development of its functional insufficiency. According to Kaufman KP (2021), the role of connective tissue in the development of ICI is confirmed by the fact, that this pathological condition of the cervix is found in women with Marfan syndrome and Ehlers-Danlos syndrome. The role of undifferentiated connective tissue dysplasia (UCTD) as a risk factor for complicated pregnancy, including ICI.Research of Huang J and co-authors (2021) found the presence of nutritional imbalance in patients with UCTD, which was manifested by changes in serum concentrations of magnesium, calcium, zinc, iron, copper, selenium, inorganic phosphorus. The relationship between changes in the microcirculation system, tissue perfusion and cervical condition is currently being actively discussed and confirmed in numerous studies.Fettweis JM (2019) believes that the mechanism of abortion at different stages of gestation is not the same in pregnant women with ICI. At the same time, all pregnant women with ICI at all stages of gestation have increased cytokine levels. However, an important factor in the premature termination of pregnancy in ICI is assigned to the infectious factor. The results of the study of the pathogenetic role of local immune responses in women with habitual miscarriage are often contradictory and dictate the need for further researches.Eventually, isthmic-cervical insufficiency is a multifactorial complication of pregnancy, in which genetic, hormonal, inflammatory-infectious, immunological or traumatic factors play a role.

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Section: «Art Of Medicine»mentioning

confidence: 99%

Section: «Art Of Medicine»mentioning

confidence: 99%

Section: «Art Of Medicine»mentioning

confidence: 99%

Section: «Art Of Medicine»mentioning

confidence: 99%

Section: «Art Of Medicine»mentioning

confidence: 99%

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Modern Aspects of the Etiopathogenesis of Istmic-Cervical Insufficiency

Levytskyi

Кінаш

2022

Scientific and practical journal

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Consequences of cervical trauma as a medical and social problem

Mochalova¹,

Ryndin²,

Mudrov³

2022

Ross. vestn. akush.-ginekol.

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Hormonal and immunological features of women with cervical insuffciency

Beglov

Артымук

2022

Fundamentalʹnaâ i kliničeskaâ medicina

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Aim. To determine the level of estradiol, progesterone, IgA and IgG to these hormones, and IgA/IgG to benzo[a]pyrene in women with cervical weakness.Materials and Methods. We retrospectively analysed case histories of 200 women, including 100 patients with cervical weakness defned by an ultrasound examination at 18-21 weeks of gestation and 100 patients without cervical weakness. Serum estradiol, progesterone, IgA and IgG to these hormones, and IgA/IgG to benzo[a]pyrene were measured at 18-21 weeks of gestation using enzyme-linked immunosorbent assay.Results. Patients with cervical weakness had a higher level of serum estradiol [12477 (1000; 31600) pg/mL], IgA to progesterone [2.15 (0.6; 8.3) a.u.] and benzo[a]pyrene [4.74 (0.4; 13.9) a.u.], IgG to estradiol [8.64 (1.2; 23.5) a.u.], progesterone [5.29 (0.2; 20.1) a.u.], and benzo[a] pyrene [11.89 (1.1; 28.5) a.u.] as compared with those without [10946 (2999; 19480) pg/mL, p = 0.034]; [1.42 (0.6; 2.6) a.u., p = 0.034]; [3.22 (0.7; 5.7) a.u., p = 0.032]; [4.78 (0.7; 8.7) a.u., p < 0.0001]; [2.55 (0.2; 5.1) a.u., p < 0.0001]; [4.72 (0.4; 10.1) a.u., p < 0.0001]. An association between the preterm birth and levels of IgA to progesterone (p = 0.00017) and benzo[a]pyrene (p = 0.0003) was established.Conclusion. Patients with cervical weakness were characterized by higher levels of IgA and IgG to estradiol, progesterone, and benzo[a]pyrene; notably, increased IgA to progesterone and benzo[a] pyrene correlated with a higher risk of preterm birth.

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Cervical Insufficiency: Classification, Etiopathogenesis, Diagnosis, Methods of Prophylaxis and Corrections (Clinical Lecture)

Cited by 4 publications

References 10 publications

Modern Aspects of the Etiopathogenesis of Istmic-Cervical Insufficiency

Modern Aspects of the Etiopathogenesis of Istmic-Cervical Insufficiency

Consequences of cervical trauma as a medical and social problem

Hormonal and immunological features of women with cervical insuffciency

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