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Progesterone in preterm birth

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https://www.readbyqxmd.com/read/29136115/estradiol-levels-are-altered-in-human-immunodeficiency-virus-infected-pregnant-women-randomized-to-efavirenz-versus-lopinavir-ritonavir-based-antiretroviral-therapy
#1
Chloe R McDonald, Andrea L Conroy, Joel L Gamble, Eszter Papp, Michael Hawkes, Peter Olwoch, Paul Natureeba, Moses Kamya, Michael Silverman, Deborah Cohan, Catherine A Koss, Grant Dorsey, Kevin C Kain, Lena Serghides
Background: Combination antiretroviral therapy (cART) use in pregnancy has been associated with hormonal dysregulation. We performed a secondary retrospective analysis of longitudinal progesterone and estradiol levels in pregnancy using specimens from the Protease Inhibitors to Reduce Malaria Morbidity in HIV-infected Pregnant Women study, which randomized Ugandan human immunodeficiency virus (HIV)-infected ART-naive women to initiate either lopinavir/ritonavir (LPV/r)-based or efavirenz (EFV)-based cART...
November 10, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29135075/the-role-of-body-mind-and-environment-in-preterm-birth-mind-the-gap
#2
REVIEW
Shelby Yamamoto, Shahirose Premji
Preterm birth continues to be a problem affecting low-, middle-, and high-income countries, with rates increasing in some areas despite ongoing efforts to reduce the incidence. This emphasizes the need for more effective interventions, particularly if we aim to achieve the broad health targets of the Sustainable Development Goals (SDGs) by 2030. The current focus on medically-oriented interventions such as reducing nonmedically-indicated induction of labor, cesarean birth, and multiple embryo transfers associated with assisted reproductive technologies, as well as the application of cervical cerclage and use of progesterone therapy, though important, are likely only partial solutions to the complex phenomenon of preterm birth...
November 14, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29112651/progesterone-for-prevention-of-preterm-birth-shortcomings-and-unintended-consequences-of-the-orphan-drug-act
#3
Rebekah E Gee, SreyRam Kuy, Laura O Karas
Preterm birth is a problem of major public health significance that continues to plague our country despite the existence of a therapy, 17α-hydroxyprogesterone caproate, with known efficacy in reducing the risk of spontaneous preterm birth among high-risk women. Over the past several years, the Louisiana Department of Health has undertaken a robust, multifaceted initiative to improve access to 17α-hydroxyprogesterone caproate, which resulted in a 3.5-fold increase in the percentage of eligible high-risk pregnant women in the Medicaid program who received the therapy between 2013 and 2016...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29094879/risk-of-preterm-birth-with-vaginal-progesterone-in-twin-pregnancies
#4
M Christine Livergood, Amanda Trudell
No abstract text is available yet for this article.
November 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/29055173/safety-and-efficacy-of-the-cervical-pessary-combined-with-vaginal-progesterone-for-the-prevention-of-spontaneous-preterm-birth
#5
Georgios Daskalakis, Dimitrios Zacharakis, Marianna Theodora, Panagiotis Antsaklis, Nikolaos Papantoniou, Dimitris Loutradis, Aris Antsaklis
INTRODUCTION: The aim of this study was to evaluate the safety and efficacy of the combined treatment of cervical pessary and endovaginal progesterone for the prevention of spontaneous preterm birth (SPB) in women with a short cervical length (CL) between 20 and 24 weeks of gestation. MATERIALS AND METHODS: This is a prospective study of women with a singleton pregnancy and a sonographically detected mid-trimester CL ≤25 mm. The primary outcome measure was spontaneous delivery before 34 weeks (238 days) of gestation...
October 21, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29031893/in-an-in%C3%A2-vitro-model-using-human-fetal-membranes-17-alpha-hydroxyprogesterone-caproate-is-not-an-optimal-progestogen-for-inhibition-of-fetal-membrane-weakening
#6
Deepak Kumar, Robert M Moore, Brian M Mercer, Joseph M Mansour, Sam Mesiano, Frederick Schatz, Charles J Lockwood, John J Moore
BACKGROUND: The progestogen 17-alpha hydroxyprogesterone caproate is 1 of only 2 agents recommended for clinical use in the prevention of spontaneous preterm delivery, and studies of its efficacy have been conflicting. We have developed an in vitro model to study the fetal membrane weakening process that leads to rupture in preterm premature rupture of the fetal membranes. Inflammation/infection associated with tumor necrosis factor-alpha induction and decidual bleeding/abruption associated thrombin release are leading causes of preterm premature rupture of the fetal membranes...
October 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29022513/discrepancies-in-animal-models-of-preterm-birth
#7
Clarence R Manuel, Charles R Ashby, Sandra E Reznik
BACKGROUND: Preterm birth (PTB) is a multifactorial syndrome occurring before the 37th week of full-term pregnancy [1]. Babies delivered preterm experience short-term and long-term complications affecting multiple organ systems, and serious maternal complications include hemorrhage and infection. Each year, an estimated 15 million babies are born preterm, and complications from prematurity are the leading cause of death among children up to 5 years of age [2]. With another increase in PTB rates over the last several years, the United States continues to have the highest incidence of any industrialized country [3]...
October 12, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28989916/use-of-progesterone-supplement-therapy-for-prevention-of-preterm-birth-review-of-literatures
#8
REVIEW
Suk-Joo Choi
Preterm birth (PTB) is one of the most common complications during pregnancy and it primarily accounts for neonatal mortality and numerous morbidities including long-term sequelae including cerebral palsy and developmental disability. The most effective treatment of PTB is prediction and prevention of its risks. Risk factors of PTB include history of PTB, short cervical length (CL), multiple pregnancies, ethnicity, smoking, uterine anomaly and history of curettage or cervical conization. Among these risk factors, history of PTB, and short CL are the most important predictive factors...
September 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28988725/prevention-of-preterm-birth-novel-interventions-for-the-cervix
#9
REVIEW
Bouchra Koullali, Andrea R Westervelt, Kristin M Myers, Michael D House
Preterm birth is the leading cause of neonatal mortality and morbidity worldwide. Spontaneous preterm birth is a complex, multifactorial condition in which cervical dysfunction plays an important role in some women. Current treatment options for cervical dysfunction include cerclage and supplemental progesterone. In addition, cervical pessary is being studied in research protocols. However, cerclage, supplemental progesterone and cervical pessary have well known limitations and there is a strong need for alternate treatment options...
October 5, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28960693/clinical-and-risk-factor-analysis-of-cloacal-defects-in-the-national-birth-defects-prevention-study
#10
Kim M Keppler-Noreuil, Kristin M Conway, Dereck Shen, Anthony J Rhoads, John C Carey, Paul A Romitti
Cloacal exstrophy (CE) and persistent cloaca (PC) (alternatively termed urorectal septum malformation sequence [URSMS]), represent two major cloacal defects (CDs). Clinical characteristics and risk factors often are studied for both defects combined, rather than exploring if these defects have different etiologies. We enumerated clinical features for 47 CE and 54 PC (inclusive of URSMS) cases from the National Birth Defects Prevention Study. Thirty-three CE cases were classified as isolated and 14 as multiple (presence of unassociated major defects); respective totals for PC cases were 26 and 28...
November 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28949973/vaginal-progesterone-pessaries-for-pregnant-women-with-a-previous-preterm-birth-to-prevent-neonatal-respiratory-distress-syndrome-the-progress-study-a-multicentre-randomised-placebo-controlled-trial
#11
RANDOMIZED CONTROLLED TRIAL
Caroline A Crowther, Pat Ashwood, Andrew J McPhee, Vicki Flenady, Thach Tran, Jodie M Dodd, Jeffrey S Robinson
BACKGROUND: Neonatal respiratory distress syndrome, as a consequence of preterm birth, is a major cause of early mortality and morbidity. The withdrawal of progesterone, either actual or functional, is thought to be an antecedent to the onset of labour. There remains limited information on clinically relevant health outcomes as to whether vaginal progesterone may be of benefit for pregnant women with a history of a previous preterm birth, who are at high risk of a recurrence. Our primary aim was to assess whether the use of vaginal progesterone pessaries in women with a history of previous spontaneous preterm birth reduced the risk and severity of respiratory distress syndrome in their infants, with secondary aims of examining the effects on other neonatal morbidities and maternal health and assessing the adverse effects of treatment...
September 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28949963/preterm-birth-prevention-time-to-progress-beyond-progesterone
#12
Jane E Norman, Phillip Bennett
In a Perspective, Jane Norman and Phillip Bennett argue that it is time to explore alternatives to progesterone for preventing preterm birth.
September 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28949010/the-value-of-oral-micronized-progesterone-in-the-prevention-of-recurrent-spontaneous-preterm-birth-a-randomized-controlled-trial
#13
Sherif Ashoush, Osama El-Kady, Gehan Al-Hawwary, Ahmed Othman
INTRODUCTION: Progesterone is becoming universally accepted for preventing recurrent spontaneous preterm delivery. There is, however, poor consensus on the effective types and doses of progesterone to be used. Despite the encouraging available research, the role of oral micronized progesterone has not yet been thoroughly investigated. MATERIAL AND METHODS: We randomized 212 singleton pregnancies with past history of spontaneous preterm delivery at <37 weeks, into a progesterone group (receiving 100 mg oral micronized progesterone, six-hourly, starting at 14-18 weeks until 37 weeks or delivery) and an identical placebo group...
September 26, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28947068/17-alpha-hydroxyprogesterone-caproate-for-preterm-birth-prevention-where-have-we-been-how-did-we-get-here-and-where-are-we-going
#14
REVIEW
Tracy A Manuck
Prematurity is a major public health problem in the United States and worldwide. Women with a history of a previous preterm birth are at high risk for recurrence. Progesterone is a key hormone involved in pregnancy maintenance. In general, progesterone is thought to maintain pregnancy through several closely linked mechanisms: (1) promotion of uterine quiescence, (2) inhibition of pro-inflammatory cells, and (3) immunosuppressive action. 17-Alpha hydroxyprogesterone caproate is currently the only medication approved to prevent recurrent preterm birth...
September 22, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28940481/prevention-of-preterm-birth-with-pessary-in-singletons-popps-a-randomized-controlled-trial
#15
Lorraine Dugoff, Vincenzo Berghella, Harish Sehdev, A Dhanya Mackeen, Laura Goetzl, Jack Ludmir
OBJECTIVE: To determine if pessary use prevents preterm birth in singleton gestations with a short transvaginal ultrasound cervical length and without a prior spontaneous preterm birth. METHODS: In this open-label multicenter randomized trial we enrolled asymptomatic women with singleton gestations with a transvaginal ultrasound cervical length ≤ 25 mm at 18(0) -23(6) weeks and no prior spontaneous preterm birth. Subjects were randomized to receive the Bioteque cup pessary or no pessary...
September 20, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28889957/pathophysiology-of-preterm-labor-with-intact-membranes
#16
REVIEW
Asha N Talati, David N Hackney, Sam Mesiano
Preterm labor with intact membranes is a major cause of spontaneous preterm birth (sPTB). To prevent sPTB a clear understanding is needed of the hormonal interactions that initiate labor. The steroid hormone progesterone acting via its nuclear progesterone receptors (PRs) in uterine cells is essential for the establishment and maintenance of pregnancy and disruption of PR signaling (i.e., functional progesterone/PR withdrawal) is key trigger for labor. The process of parturition is also associated with inflammation within the uterine tissues and it is now generally accepted that inflammatory stimuli from multiple extrinsic and intrinsic sources induce labor...
November 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28889776/risk-of-spontaneous-preterm-birth-in-ivf-conceived-twin-pregnancies
#17
Gabriele Saccone, Fabrizio Zullo, Amanda Roman, Andrew Ward, Giuseppe Maruotti, Pasquale Martinelli, Vincenzo Berghella
OBJECTIVE: To compare the mean transvaginal ultrasound (TVU) cervical length (CL) at midtrimester in screening for preterm birth in in vitro (IVF)-conceived twin pregnancies versus spontaneously-conceived twin pregnancies. METHODS: This was a retrospective cohort study. Potential study subjects were identified at the time of a routine second trimester fetal ultrasound exam at 18 0/7 to 23 6/7-week gestation. All women with twin diamniotic pregnancies screened with a single TVU CL for this trial were included...
September 21, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28870155/pessary-or-progesterone-to-prevent-preterm-delivery-in-women-with-short-cervical-length-the-quadruple-p-randomised-controlled-trial
#18
Maud D van Zijl, Bouchra Koullali, Christiana A Naaktgeboren, Ewoud Schuit, Dick J Bekedam, Etelka Moll, Martijn A Oudijk, Wilhelmina M van Baal, Marjon A de Boer, Henricus Visser, Joris van Drongelen, Flip W van de Made, Karlijn C Vollebregt, Moira A Muller, Mireille N Bekker, Jozien T J Brons, Marieke Sueters, Josje Langenveld, Maureen T Franssen, Nico W Schuitemaker, Erik van Beek, Hubertina C J Scheepers, Karin de Boer, Eveline M Tepe, Anjoke J M Huisjes, Angelo B Hooker, Evelyn C J Verheijen, Dimitri N Papatsonis, Ben Willem J Mol, Brenda M Kazemier, Eva Pajkrt
BACKGROUND: Preterm birth is in quantity and in severity the most important topic in obstetric care in the developed world. Progestogens and cervical pessaries have been studied as potential preventive treatments with conflicting results. So far, no study has compared both treatments. METHODS/DESIGN: The Quadruple P study aims to compare the efficacy of vaginal progesterone and cervical pessary in the prevention of adverse perinatal outcome associated with preterm birth in asymptomatic women with a short cervix, in singleton and multiple pregnancies separately...
September 4, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28863997/micronized-progesterone-pretreatment-affects-the-inflammatory-response-of-human-gestational-tissues-and-the-cervix-to-lipopolysaccharide-stimulation
#19
Tai-Ho Hung, Szu-Fu Chen, Chung-Pu Wu, Meng-Jen Li, Yi-Lin Yeh, T'sang-T'ang Hsieh
INTRODUCTION: Vaginal administration of micronized progesterone (utrogestan capsule, UG) reduces the risk of preterm birth (PTB) in asymptomatic women with a sonographic short cervix at mid-trimester or with a prior history of spontaneous PTB; however, its exact mechanisms remain unclear. We hypothesized that UG limits the inflammatory processes within the gestational tissues and the cervix. METHODS: Fetal membranes and villous tissues were obtained from normal term placentas from women with cesarean delivery before labor onset...
September 2017: Placenta
https://www.readbyqxmd.com/read/28857251/hospital-admission-for-hyperemesis-gravidarum-in-women-at-increased-risk-of-spontaneous-preterm-birth
#20
Ira Kleine, Ana Da Silva, Wafaa Ahmed, Frida Forya, Sara M Whitten, Anna L David, Catherine P James
BACKGROUND: Progesterone administration prevents spontaneous preterm birth (sPTB) in women at increased risk. Progesterone concentration is lower in women with subsequent sPTB. Conversely, high concentrations of progesterone are implicated in the pathogenesis of hyperemesis gravidarum (HG). We hypothesized that women at increased risk of sPTB or spontaneous late miscarriage would be less likely to have a diagnosis of HG. To explore this hypothesis, we compared the incidence of HG in women at increased risk of sPTB and women with no identifiable risk factors...
August 30, 2017: Birth
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