Peculiarities of the course of pregnancy in women with premature birth




course of pregnancy, premature birth, major obstetric syndromes, preeclampsia, placental insufficiency, pregnancy, women


Purpose - to determine the peculiarities of the course of pregnancy and childbirth in women who had complications from the group of major obstetric syndromes, clinically manifested by premature birth (PB).

Materials and methods. A retrospective clinical-statistical analysis of the course of pregnancy and childbirth of n=69 pregnant women with spontaneous PB at a gestation period of 24-36 weeks and 6 days was carried out. Depending on the period of pregnancy, they were divided into groups: the Group I - 9 pregnant women 24-26 weeks 6 days, the Group II - 28 women 28-31 weeks 6 days, the Group III - pregnant women 32-36 weeks 6 days. The Control group (CG) consisted of 56 practically healthy pregnant women with a healthy reproductive history and an uncomplicated course of this pregnancy. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistica 6.0 programs.

Results. Were received significant differences between the Group I and the CG (p=0.007), in the presence of signs of the threat of termination of pregnancy during the second “wave” of cytotrophoblast invasion, so the chance of giving birth in the early term is 4.2 times higher than at term. In the presence of isthmic-cervical insufficiency (ICN), the reliability of differences between the Groups I and II (p=0.0021), Groups I and III (p=0.012) is observed between the Group I and CG (p=0.00083) and the risk of very early PB is 2.6 times higher than the risk of premature, late premature - 2.2 times. Disturbances in uteroplacental blood circulation have the presence of significant differences between Groups I and II (р=0.0051). There is a direct relationship between the level of blood pressure and blood circulation in the uterine arteries. Therefore, the observed difference is not accidental: in the Group II, preeclampsia was observed significantly more often. Violation of feto-placental hemodynamics when comparing groups demonstrated the existence of statistically significant differences between the Groups I and II (p=0.048), as well as between the Group I and CG (p=0.02). In the presence of clinical signs of fetal growth retardation syndrome (GRS), there is a significant difference between the Groups I and II (р=0.033).

Conclusions.The features of the course of pregnancy with premature birth include the threat of termination during the second “wave” of cytotrophoblast invasion; isthmic-cervical insufficiency, which can lead to very early premature birth; vaginal infectious-inflammatory and dysbiotic diseases. Severe forms of placental insufficiency and preeclampsia are more often an indication for termination of pregnancy at 28-33 weeks 6 days.

The research was conducted according to principles of Declaration of Helsinki. Protocol of research was proved by local ethical committee, mentioned in institution’s work. A informed sonsennt was collected in order to carry out the research.

No conflict of interests was declared by the author.


Brosens I et al. (2011). The "Great Obstetrical Syndromes" are associated with disorders of deep placentation. American journal of obstetrics and gynecology. 204 (3): 193-201.; PMid:21094932 PMCid:PMC3369813

Brosens I, Puttemans P, Benagiano G. (2019). Placental bed research: I. The placental bed: from spiral arteries remodeling to the great obstetrical syndromes. American journal of obstetrics and gynecology. 221 (5): 437-456.; PMid:31163132

Di Renzo GC. (2009). The great obstetrical syndromes. The Journal of Maternal-Fetal & Neonatal Medicine. 22 (8): 633-635.; PMid:19736613

Di Renzo, Giancarlo C et al. (2017). Preterm labor and birth management: recommendations from the European Association of Perinatal Medicine. The Journal of Maternal-Fetal & Neonatal Medicine. 30; 17: 2011-2030.; PMid:28482713

Docheva N, Romero R, Chaemsaithong P, Tarca AL, Bhatti G, Pacora P et al. (2019). The profiles of soluble adhesion molecules in the "great obstetrical syndromes". The Journal of Maternal-Fetal & Neonatal Medicine. 32 (13): 2113-2136.; PMid:29320948 PMCid:PMC6070437

Fischer LA, Demerath E, Bittner-Eddy P, Costalonga M. (2019). Placental colonization with periodontal pathogens: the potential missing link. American journal of obstetrics and gynecology. 221 (5): 383-392.; PMid:31051120 PMCid:PMC6821581

Hychka NM. (2019). Features of pregnancy, delivery, the condition of the fetus and newborn in women with miscarriage in history (Retrospective analysis). Health of woman. 3 (139): 44-48.

Kusa OM, Pakharenko LV, Basyuga IO. (2021). Miscarriage: the main etiopathogenetic aspects of isth-mic-cervical pathology. X International Scientific and Practical Conference «Topical issues, achievements and innovations of fundamental and applied sciences»: 171-173].

Mintser AP. (2018). Statisticheskie metodyi issledovaniya v klinicheskoy meditsine. Prakticheskaya meditsina. 3: 41-45.

Mosendz OV. (2021). Causes and clinic of very early preterm birth. Reproductive Health of Women. 6: 44-49.

Owens DK, Davidson KW, Krist AH et al. (2020). Screening for Bacterial Vaginosis in Pregnant Persons to Prevent Preterm Delivery: US Preventive Services Task Force Recommendation Statement. JAMA. 323; 13: 1286-1292.; PMid:32259236

Romero R et al. (2022). Toward a new taxonomy of obstetrical disease: improved performance of maternal blood biomarkers for the great obstetrical syndromes when classified according to placental pathology. American Journal of Obstetrics and Gynecology. 227 (4): 615-e1.; PMid:36180175 PMCid:PMC9525890

Romero R, Miranda J, Chaemsaithong P, Chaiworapongsa T, Kusanovic JP, Dong Z et al. (2015). Sterile and microbial-associated intra-amniotic inflammation in preterm prelabor rupture of membranes. The journal of maternal-fetal & neonatal medicine. 28 (12): 1394-1409.; PMid:25190175 PMCid:PMC5371030

Romero R, Miranda J, Kusanovic JP, Chaiworapongsa T, Chaemsaithong P, Martinez A et al. (2015). Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques. Journal of perinatal medicine. 43 (1): 19-36.

Shevchenko A, Syusyuka V, Kyryliuk A, Deynichenko O, Onopchenko S. (2022). Preterm labor in modern obstetrics. Sciences of Europe. (91-1): 45-51.

Solovei VM. (2020). Diahnostyka platsentarnoi dysfunktsii ta prohnozuvannia perynatalnykh uskladnen u zhinok iz nevynoshuvanniam u ranni terminy hestatsii (ohliad literatury). Klinichna ta eksperymentalna patolohiia. URL:

Susidko O, Kizok O. (2023). Nevynoshuvannia ta perynatalna patolohiia u zhinok pislia nevdalykh sprob dopomizhnykh reproduktyvnykh tekhnolohii. Perinatology and reproductology: from research to practice. 3 (1): 38-43.

Susidko O. (2023). Perynatalna patolohiia u zhinok z reproduktyvnymy vtratamy v anamnezi. Perinatology and reproductology: from research to practice. 3 (2): 36-43.

Sweeting A, Park F, Hyett J. (2015). The first trimester: prediction and prevention of the great obstetrical syndromes. Best practice & research Clinical obstetrics & gynaecology. 29 (2): 183-193.; PMid:25482532

Walani SR. (2020). Global burden of preterm birth. Int J Gynecol Obstet. 150: 31-33.; PMid:32524596