• Home
  • NEW DAY MEDICINE
  • 4 (78) 2025
  • 2 -4 (78) 2025 - E.A. Mitskevich, N.N. Yarotskaya - PREDICTION OF PREGNANCY OUTCOMES IN PATIENTS WITH CERVICAL INSUFFICIENCY BASED ON MARKERS OF DEGRADATION OF INTERCELLULAR SUBSTANCE OF CONNECTIVE TISSUE OF THE CERVIX

2 -4 (78) 2025 - E.A. Mitskevich, N.N. Yarotskaya - PREDICTION OF PREGNANCY OUTCOMES IN PATIENTS WITH CERVICAL INSUFFICIENCY BASED ON MARKERS OF DEGRADATION OF INTERCELLULAR SUBSTANCE OF CONNECTIVE TISSUE OF THE CERVIX

PREDICTION OF PREGNANCY OUTCOMES IN PATIENTS WITH CERVICAL INSUFFICIENCY BASED ON MARKERS OF DEGRADATION OF INTERCELLULAR SUBSTANCE OF CONNECTIVE TISSUE OF THE CERVIX

E.A. Mitskevich - Educational institution "Vitebsk State Order of Peoples' Friendship Medical University"

N.N. Yarotskaya - Educational institution "Vitebsk State Order of Peoples' Friendship Medical University"

Resume

The relevance of the study is associated with the subjectivity of existing methods for diagnosing cervical insufficiency (CI). Palpation and ultrasound examination of the cervix are operator-dependent, their results may contradict each other. Currently, there is no laboratory marker of premature ripening of the cervix that would allow diagnosing CI and predicting pregnancy outcome. The aim of the study was to evaluate the clinical significance of determining hyaluronic acid and neuraminidase in relation to the implementation of CI and predicting pregnancy outcomes. Materials and methods. The study involved 95 healthy pregnant women and those with CI. Using enzyme-linked immunosorbent assay (ELISA), the concentration of hyaluronic acid and neuraminidase in cervical mucus and urine was estimated. Results. The concentration of hyaluronic acid and neuraminidase changes during pregnancy in both healthy pregnant women and patients with CI. The study revealed a relationship between the concentration of hyaluronic acid and neuraminidase in urine and cervical mucus and the onset of CI and the subsequent duration of pregnancy. The concentration of neuraminidase in cervical mucus of 1480.00 pg/ml and above corresponded to clinical manifestations of CI, and its values of 470.00 pg/ml and less (p≤0.05) at the onset of CI - to a low risk of preterm labor. Neuraminidase values in cervical mucus of 12,000 pg/ml and above were associated with very early and early preterm labor in pregnant women with CI. Conclusion. Many risk factors for CI are uncontrollable during pregnancy. However, understanding the processes of transformation of the intercellular substance of the connective tissue of the cervix allows timely determination of the direction and amount of medical care. The introduction of laboratory diagnostics of the concentration of hyaluronic acid and neuraminidase in urine and cervical mucus in pregnant women at risk of CI at 18 weeks of pregnancy and at 26 weeks of pregnancy will improve perinatal pregnancy outcomes.

Keywords. Сervical insufficiency, premature labor, hyaluronic acid, neuraminidase.

First page

8

Last page

17

For citation:E.A. Mitskevich, N.N. Yarotskaya - PREDICTION OF PREGNANCY OUTCOMES IN PATIENTS WITH CERVICAL INSUFFICIENCY BASED ON MARKERS OF DEGRADATION OF INTERCELLULAR SUBSTANCE OF CONNECTIVE TISSUE OF THE CERVIX//New Day in Medicine 4(78)2025 8-17 https://newdayworldmedicine.com/en/new_day_medicine/4-78-2025

List of References

  1. Rouholamin S, Razavi M, Rezaeinejad M, Sepidarkish M. A diagnostic profile on the PartoSure test. Expert Rev Mol Diagn. 2020 Dec;20(12):1163-1170. doi: 10.1080/14737159.2020.1848549. Epub 2020 Dec 16. PMID: 33175636.
  2. Getahun D, Sacks DA, Shi J, Xie F, Khadka N, Chiu VY, Mensah NA, Avila CC, Yeh M, Kawatkar AA, Ruma MS, Joyce D, Fassett MJ. Management, Utilization, and Outcomes of Preterm Labor in an Integrated Health Care System. Am J Perinatol. 2024 Dec;41(16):2214-2221. doi: 10.1055/s-0044-1786545. Epub 2024 May 7. PMID: 38714204.
  3. Bennett PR, Brown RG, MacIntyre DA. Vaginal Microbiome in Preterm Rupture of Membranes. Obstet Gynecol Clin North Am. 2020 Dec;47(4):503-521. doi: 10.1016/j.ogc.2020.08.001. PMID: 33121642.
  4. Salmanov AG, Artyomenko V, Koctjuk IM, Mashyr NV, Berestooy OA, Beraia DY. CERVICITIS AS A CAUSE OF PRETERM BIRTH IN WOMEN. Wiad Lek. 2022;75(11 pt 2):2715-2721. doi: 10.36740/WLek202211201. PMID: 36591758.
  5. Ansaldi Y, Martinez de Tejada Weber B. Urinary tract infections in pregnancy. Clin Microbiol Infect. 2023 Oct;29(10):1249-1253. doi: 10.1016/j.cmi.2022.08.015. Epub 2022 Aug 27. PMID: 36031053.
  6. Ганчар Е.П., Колесникова Т.А., Сайковская В.Э., Кажина М.В. Возможности профилактики истмико-цервикальной недостаточности // Актуальные вопросы перинатологии : материалы областной юбилейной научно-практической конференции, посвященной 75-летию учреждения здравоохранения «Гродненский областной клинический перинатальный центр». – Гродно, 2020. p.43-46. [Ganchar EP, Kolesnikova TA, Saykovskaya VE, Kazhina MV. Possibilities of prevention of cervical insufficiency // Aktualnye voprosy perinatologii: materialy oblastnoy ubileinoi nauchno-prakticheskoi konferencii, posviaschennoi 75-letiu uchrezhdeniia zdravoohraneniia «Grodnenskiy oblastnoi klinicheskii perinatalnyi centr». - Grodno, 2020. p.43-46.]
  7. Pakharenko L, Perkhulyn O, Henyk N, Matviykiv N. Evaluation of the risk factors of cervical insufficiency in women with infertility associated with anovulation. Georgian Med News. 2020 Jan;(298):27-33. PMID: 32141843.
  8. Meng L, Öberg S, Sandström A, Wang C, Reilly M. Identification of risk factors for incident cervical insufficiency in nulliparous and parous women: a population-based case-control study. BMC Med. 2022 Oct 12;20(1):348. doi: 10.1186/s12916-022-02542-7. PMID: 36221132; PMCID: PMC9555073.
  9. Мицкевич Е.А. Факторы риска самопроизвольного выкидыша у беременных женщин с истмико-цервикальной недостаточностью // Достижения фундам., клин. медицины и фармации : материалы 77 науч. сессии ВГМУ. – Витебск : ВГМУ, 2023. c. 123-126. [Mitskevich EA. Risk factors for spontaneous miscarriage in pregnant women with isthmic-cervical insufficiency // Dostizheniia fund., klin. mediciny i farmacii : materialy 77 nauch. ceccii VSMU. - Vitebsk: VSMU, 2023. p. 123-126.]
  10. Мицкевич Е.А., Дивакова Т.С., Разина М.Ф., Мелешко Ю.В. Прогнозирование исходов беременности у пациентов с истмико-цервикальной недостаточностью // Вестник ВГМУ. – 2022;№ 5 (21):56-68. [Mitskevich EA, Divakova TS, Razina MF, Meleshko YuV. Prediction of pregnancy outcomes in patients with cervical insufficiency // Vestnik of VSMU. - 2022; No. 5 (21): 56-68.]
  11. Yeo L, Romero R, Chaiworapongsa T, Para R, Johnson J, Kmak D, Jung E, Yoon BH, Hsu CD. Resolution of acute cervical insufficiency after antibiotics in a case with amniotic fluid sludge. J Matern Fetal Neonatal Med. 2022 Dec;35(25):5416-5426. doi: 10.1080/14767058.2021.1881477. Epub 2021 Feb 17. PMID: 33596766; PMCID: PMC8521637.
  12. Ng S, Chen M, Kundu S, Wang X, Zhou Z, Zheng Z, Qing W, Sheng H, Wang Y, He Y, Bennett PR, MacIntyre DA, Zhou H. Large-scale characterisation of the pregnancy vaginal microbiome and sialidase activity in a low-risk Chinese population. NPJ Biofilms Microbiomes. 2021 Dec 20;7(1):89. doi: 10.1038/s41522-021-00261-0. PMID: 34930922; PMCID: PMC8688454.
  13. Cauci S, Culhane JF. High sialidase levels increase preterm birth risk among women who are bacterial vaginosis-positive in early gestation. Am J Obstet Gynecol. 2011 Feb;204(2):142.e1-9. doi: 10.1016/j.ajog.2010.08.061. Epub 2010 Nov 5. PMID: 21055720.
  14. Barinov SV, Tirskaya YI, Kadsyna TV, Lazareva OV, Medyannikova IV, Tshulovski YI. Pregnancy and delivery in women with a high risk of infection in pregnancy. J Matern Fetal Neonatal Med. 2022 Jun;35(11):2122-2127. doi: 10.1080/14767058.2020.1781810. Epub 2020 Jun 23. PMID: 32576052.
  15. Khayargoli P, Mayrand MH, Niyibizi J, Audibert F, Laporte L, Lacaille J, Carceller AM, Lacroix J, Comète É, Coutlée F, Trottier H; HERITAGE Study Group. Association between Human Papillomavirus 16 Viral Load in Pregnancy and Preterm Birth. Viruses. 2024 Feb 15;16(2):298. doi: 10.3390/v16020298. PMID: 38400073; PMCID: PMC10892609.
  16. Wu G, Grassi P, Molina BG, MacIntyre DA, Sykes L, Bennett PR, Dell A, Haslam SM. Glycomics of cervicovaginal fluid from women at risk of preterm birth reveals immuno-regulatory epitopes that are hallmarks of cancer and viral glycosylation. Sci Rep. 2024 Sep 6;14(1):20813. doi: 10.1038/s41598-024-71950-x. PMID: 39242814; PMCID: PMC11379862.
  17. Stout MJ, Brar AK, Herter BN, Rankin A, Wylie KM. The plasma virome in longitudinal samples from pregnant patients. Front Cell Infect Microbiol. 2023 Feb 9;13:1061230. doi: 10.3389/fcimb.2023.1061230. PMID: 36844406; PMCID: PMC9949529.
  18. Niyibizi J, Mayrand MH, Audibert F, Monnier P, Brassard P, Laporte L, Lacaille J, Zahreddine M, Bédard MJ, Girard I, Francoeur D, Carceller AM, Lacroix J, Fraser W, Coutlée F, Trottier H; HERITAGE Study Group. Association Between Human Papillomavirus Infection Among Pregnant Women and Preterm Birth. JAMA Netw Open. 2021 Sep 1;4(9):e2125308. doi: 10.1001/jamanetworkopen.2021.25308. PMID: 34524433; PMCID: PMC8444026.
  19. Gholizadeh O, Yekanipour Z, Kivi S, Farahbod F, Aqayinejad M, Tasoujizade Y, Yasamineh S, Amini P, Akbarzadeh S, Hajiesmaeili M, Poortahmasebi V. Review of the evidence of the effects of human papillomavirus infection and Gardnerella vaginalis, and their co-infection on infertility. Microb Pathog. 2023 Feb;175:105980. doi: 10.1016/j.micpath.2023.105980. Epub 2023 Jan 12. PMID: 36642287.
  20. Медицинское наблюдение и оказание медицинской помощи женщинам в акушерстве и гинекологии : клинический протокол: утв. М-вом здравоохранения Респ. Беларусь 19.02.2018 / Вильчук К.У. – Минск, 2018. – 203 с. [Medicinskoe nabludenie i okazanie medicinskoi pomoshci zhenshchinam v akusherstve i ginecologii: klinicheskii protocol: utv. Ministerstvom zdravoohraneniia Respubliki Belarus 19.02.2018 / Vilchuk KU. - Minsk, 2018: 203 p.]

    file

    download