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Progesterone in preterm birth

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https://www.readbyqxmd.com/read/28594783/progestogens-for-maintenance-tocolysis-in-women-with-a-short-cervix-a-randomized-controlled-trial
#1
Fabio Facchinetti, Patrizia Vergani, Mariarosaria Di Tommaso, Luca Marozio, Barbara Acaia, Roberto Vicini, Lucrezia Pignatti, Anna Locatelli, Marina Spitaleri, Chiara Benedetto, Barbara Zaina, Roberto DʼAmico
OBJECTIVE: To assess the efficacy of progestogens for maintenance tocolysis in women undelivered after their first preterm labor episode. METHODS: Women with singleton pregnancies between 22 0/7 and 31 6/7 weeks of gestation with arrested preterm labor and a cervical length 25 mm or less at hospital discharge were eligible. Patients with a previous preterm birth were excluded. In a randomized controlled trial conducted in five university hospitals, women were randomized to receive vaginal progesterone (200 mg per day) or intramuscular 17α-hydroxyprogesterone caproate (341 mg per week) or to an observation groups (control group)...
June 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28586127/cervical-stitch-cerclage-for-preventing-preterm-birth-in-singleton-pregnancy
#2
REVIEW
Zarko Alfirevic, Tamara Stampalija, Nancy Medley
BACKGROUND: Cervical cerclage is a well-known surgical procedure carried out during pregnancy. It involves positioning of a suture (stitch) around the neck of the womb (cervix), aiming to give mechanical support to the cervix and thereby reduce risk of preterm birth. The effectiveness and safety of this procedure remains controversial. This is an update of a review last published in 2012. OBJECTIVES: To assess whether the use of cervical stitch in singleton pregnancy at high risk of pregnancy loss based on woman's history and/or ultrasound finding of 'short cervix' and/or physical exam improves subsequent obstetric care and fetal outcome...
June 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28578177/the-impact-of-uterine-immaturity-on-obstetrical-syndromes-during%C3%A2-adolescence
#3
Ivo Brosens, Joanne Muter, Caroline Gargett, Patrick Puttemans, Giuseppe Benagiano, Jan J Brosens
Pregnant nulliparous adolescents are at increased risk, inversely proportional to their age, of major obstetric syndromes, including preeclampsia, fetal growth restriction, and preterm birth. Emerging evidence indicates that biological immaturity of the uterus accounts for the increased incidence of obstetrical disorders in very young mothers, possibly compounded by sociodemographic factors associated with teenage pregnancy. The endometrium in most newborns is intrinsically resistant to progesterone signaling, and the rate of transition to a fully responsive tissue likely determines pregnancy outcome during adolescence...
May 31, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28559440/bitter-taste-receptors-as-targets-for-tocolytics-in-preterm-labor-therapy
#4
Kaizhi Zheng, Ping Lu, Ellen Delpapa, Karl Bellve, Ruitang Deng, Jennifer C Condon, Kevin Fogarty, Lawrence M Lifshitz, Tiffany A Moore Simas, Fangxiong Shi, Ronghua ZhuGe
Preterm birth (PTB) is the leading cause of neonatal mortality and morbidity, with few prevention and treatment options. Uterine contraction is a central feature of PTB, so gaining new insights into the mechanisms of this contraction and consequently identifying novel targets for tocolytics are essential for more successful management of PTB. Here we report that myometrial cells from human and mouse express bitter taste receptors (TAS2Rs) and their canonical signaling components (i.e., G-protein gustducin and phospholipase C β2)...
May 30, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28549981/early-pregnancy-vaginal-microbiome-trends-and-preterm-birth
#5
Molly J Stout, Yanjiao Zhou, Kristine M Wylie, Phillip I Tarr, George A Macones, Methodius G Tuuli
BACKGROUND: Despite decades of attempts to link infectious agents to preterm birth, an exact causative microbe or community of microbes remains elusive. Non-culture 16S ribosomal RNA gene sequencing suggests important racial differences and pregnancy specific changes in the vaginal microbial communities. A recent study examining the association of the vaginal microbiome and preterm birth documented important findings but was performed in a predominantly White cohort. Given the important racial differences in bacterial communities within the vagina as well as persistent racial disparities in preterm birth it is important to examine cohorts with varied demographic compositions...
May 23, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28527571/progesterone-receptor-signaling-in-uterine-myometrial-physiology-and-preterm-birth
#6
San-Pin Wu, Francesco J DeMayo
Myometrium holds the structural integrity for the uterus and generates force for parturition with its primary component, the smooth muscle cells. The progesterone receptor mediates progesterone-dependent signaling and connects to a network of pathways for regulation of contractility and inflammatory responses in myometrium. Dysfunctional progesterone signaling has been linked to pregnancy complications including preterm birth. In the present review, we summarize recent findings on modifiers and effectors of the progesterone receptor signaling...
2017: Current Topics in Developmental Biology
https://www.readbyqxmd.com/read/28522317/the-association-among-cytochrome-p450-3a-progesterone-receptor-polymorphisms-plasma-17-alpha-hydroxyprogesterone-caproate-concentrations-and-spontaneous-preterm-birth
#7
Martha L Bustos, Steve N Caritis, Kathleen A Jablonski, Uma M Reddy, Yoram Sorokin, John M Thorp, Michael W Varner, Ronald J Wapner, Jay D Iams, Marshall W Carpenter, Alan M Peaceman, Brian M Mercer, Anthony Sciscione, Dwight J Rouse, Susan M Ramin
BACKGROUND: Infants born <37 weeks' gestation are of public health concern since complications associated with preterm birth are the leading cause of mortality in children <5 years of age and a major cause of morbidity and lifelong disability. The administration of 17-alpha hydroxyprogesterone caproate reduces preterm birth by 33% in women with history of spontaneous preterm birth. We demonstrated previously that plasma concentrations of 17-alpha hydroxyprogesterone caproate vary widely among pregnant women and that women with 17-alpha hydroxyprogesterone caproate plasma concentrations in the lowest quartile had spontaneous preterm birth rates of 40% vs rates of 25% in those women with higher concentrations...
May 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28502186/effectiveness-of-dydrogesterone-17-oh-progesterone-and-micronized-progesterone-in-prevention-of-preterm-birth-in-women-with-a-short-cervix
#8
Olga Pustotina
OBJECTIVE: To compare the efficacy of dydrogesterone, 17-OH progesterone (17OHP) and oral or vaginal micronized progesterone with cerclage for the prevention of preterm birth in women with a short cervix. METHODS: The study included 95 women with singleton gestation and cervical length (CL) ≤ 25 mm. Among these, 35 women were asymptomatic at 15-24 weeks and 60 had symptoms of threatened late miscarriage (LM) or preterm delivery (PD) at 15-32 weeks. Patients were randomized to receive dydrogesterone, 17OHP or oral/vaginal micronized progesterone; after one week of therapy 15 women underwent cerclage...
May 29, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28494594/caring-for-baby-s-teeth-starts-before-birth
#9
EDITORIAL
L Paglia
Care for a child's teeth and gums can start even before the baby is born. Pregnancy causes many hormonal changes, among these the rise of estrogen and progesterone increases the risk of developing oral health problems, like gingivitis and periodontitis.The presence of maternal periodontal diseases and active infections has been associated with adverse pregnancy outcomes, such as preterm birth, preeclampsia, gestational diabetes and foetal loss. Therefore, it is important to educate pregnant women about their oral hygiene and the importance of taking care of their newborn's oral health...
March 2017: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/28395330/contributions-to-the-dynamics-of-cervix-remodeling-prior-to-term-and-preterm-birth
#10
Steven M Yellon
Major clinical challenges for obstetricians and neonatologists result from early cervix remodeling and preterm birth. Complications related to cervix remodeling or delivery account for significant morbidity in newborns and peripartum mothers. Understanding morphology and structure of the cervix in pregnant women is limited mostly to the period soon before and after birth. However, evidence in rodent models supports a working hypothesis that a convergence of factors promotes a physiological inflammatory process that degrades the extracellular collagen matrix and enhances biomechanical distensibility of the cervix well before the uterus develops the contractile capabilities for labor...
January 1, 2017: Biology of Reproduction
https://www.readbyqxmd.com/read/28347715/preeclampsia-novel-insights-from-global-rna-profiling-of%C3%A2-trophoblast-subpopulations
#11
Matthew Gormley, Katherine Ona, Mirhan Kapidzic, Tamara Garrido-Gomez, Tamara Zdravkovic, Susan J Fisher
BACKGROUND: The maternal signs of preeclampsia, which include the new onset of high blood pressure, can occur because of faulty placentation. We theorized that transcriptomic analyses of trophoblast subpopulations in situ would lend new insights into the role of these cells in preeclampsia pathogenesis. OBJECTIVE: Our goal was to enrich syncytiotrophoblasts, invasive cytotrophoblasts, or endovascular cytotrophoblasts from the placentas of severe preeclampsia cases...
March 24, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28323976/protective-effects-of-fetal-zone-steroids-are-comparable-to-estradiol-in-hyperoxia-induced-cell-death-of-immature-glia
#12
Stephanie Hübner, Donna E Sunny, Christine Pöhlke, Johanna Ruhnau, Antje Vogelgesang, Bettina Reich, Matthias Heckmann
Impaired neurodevelopment in preterm infants is caused by prematurity itself; however, hypoxia/ischemia, inflammation, and hyperoxia contribute to the extent of impairment. Because preterm birth is accompanied by a dramatic decrease in 17β-estradiol (E2) and progesterone, preliminary clinical studies have been carried out to substitute these steroids in preterm infants; however, they failed to confirm significantly improved neurological outcomes. We therefore hypothesized that the persistently high postnatal production of fetal zone steroids (mainly dehydroepiandrosterone (DHEA)) until term could interfere with E2-mediated protection...
March 3, 2017: Endocrinology
https://www.readbyqxmd.com/read/28319314/progesterone-to-prevent-preterm-birth-the-studies-are-getting-better-but-there-is-still-room-for-improvement
#13
C M Chung, M van Zijl, J A Keelan, B W Mol
No abstract text is available yet for this article.
June 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28295170/implementing-universal-cervical-length-screening-in-asymptomatic-women-with-singleton-pregnancies-challenges-and-opportunities
#14
Michelle K Pedretti, Brenda M Kazemier, Jan E Dickinson, Ben W J Mol
Cervical length (CL) screening has been successfully utilised to identify asymptomatic women, with a singleton pregnancy, at risk of preterm birth (PTB), thereby providing an opportunity to offer interventions that may reduce that risk. Cervical length screening with ultrasound is most effectively performed with a transvaginal approach. Universal cervical length screening, encompassing all singleton pregnancies rather than restricting screening to those considered at increased risk of PTB, is currently not widely used, despite a growing body of evidence in support of its utility for PTB prevention...
April 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28278220/placental-hormone-profiles-as-predictors-of-preterm-birth-in-twin-pregnancy-a-prospective-cohort-study
#15
Hui Lim, Sioned Powell, Helen C Mcnamara, A Forbes Howie, Ann Doust, Maria E Bowman, Roger Smith, Jane E Norman, Sarah J Stock
OBJECTIVE: The objective of the study was to analyse placental hormone profiles in twin pregnancies to determine if they could be used to predict preterm birth. STUDY DESIGN: Progesterone, estradiol, estriol and corticotropin-releasing hormone were measured using competitive immunoassay and radioimmunoassay in serum and saliva samples of 98 women with twin pregnancies,at 3 or more gestational timepoints. Hormone profiles throughout gestation were compared between very preterm (<34 weeks; n = 8), preterm (<37 weeks; n = 40) and term (37+ weeks; n = 50) deliveries...
2017: PloS One
https://www.readbyqxmd.com/read/28276151/effectiveness-of-progesterone-cerclage-and-pessary-for-preventing-preterm-birth-in-singleton-pregnancies-a-systematic-review-and-network-meta-analysis
#16
A Jarde, O Lutsiv, C K Park, J Beyene, J M Dodd, J Barrett, P S Shah, J L Cook, S Saito, A B Biringer, L Sabatino, L Giglia, Z Han, K Staub, W Mundle, J Chamberlain, S D McDonald
BACKGROUND: Preterm birth (PTB) is the leading cause of infant death, but it is unclear which intervention is best to prevent it. OBJECTIVES: To compare progesterone, cerclage and pessary, determine their relative effects and rank them. SEARCH STRATEGY: We searched Medline, EMBASE, CINAHL, Cochrane CENTRAL and Web of Science (to April 2016), without restrictions, and screened references of previous reviews. SELECTION CRITERIA: We included randomised trials of progesterone, cerclage or pessary for preventing PTB in women with singleton pregnancies at risk as defined by each study...
March 9, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28220618/progesterone-pessary-or-cerclage-for-preterm-birth-prevention-in-twins-no-answers-yet
#17
J R Biggio
No abstract text is available yet for this article.
July 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28215678/the-impact-of-ovarian-stimulation-protocol-on-oocyte-quality-subsequent-in%C3%A2-vitro-embryo-development-and-pregnancy-after-transfer-to-recipients-in-eld-s-deer-rucervus-eldii-thamin
#18
Ampika Thongphakdee, Debra K Berg, Theerawat Tharasanit, Nikorn Thongtip, Wanlaya Tipkantha, Chainarong Punkong, Daraka Tongthainan, Sakhon Noimoon, Umaporn Maikeaw, Nudthakamol Kajornklin, Boripat Siriaroonrat, Pierre Comizzoli, Sumate Kamolnorranath
Propagating genetically valuable individuals through oocyte collection, in vitro fertilization (IVF) and embryo transfer is critical to maintain sustainable populations of the endangered Eld's deer. The objectives of this study were to assess the impact of exogenous FSH injections on (1) the number and in vitro competence of oocytes collected and (2) the developmental potential of resulting IVF embryos after transfer into recipients during the breeding season (February-April). In a pilot experiment, estrus synchronization was conducted in three surplus females (using intravaginal progesterone-releasing devices, CIDRG for 14 days and injections of buserelin (a GnRH agonist)...
March 15, 2017: Theriogenology
https://www.readbyqxmd.com/read/28176485/preterm-birth-prevention-in-twin-pregnancies-with-progesterone-pessary-or-cerclage-a-systematic-review-and-meta-analysis
#19
REVIEW
A Jarde, O Lutsiv, C K Park, J Barrett, J Beyene, S Saito, J M Dodd, P S Shah, J L Cook, A B Biringer, L Giglia, Z Han, K Staub, W Mundle, C Vera, L Sabatino, S K Liyanage, S D McDonald
BACKGROUND: About half of twin pregnancies deliver preterm, and it is unclear whether any intervention reduces this risk. OBJECTIVES: To assess the evidence for the effectiveness of progesterone, cerclage, and pessary in twin pregnancies. SEARCH STRATEGY: We searched Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ISI Web of Science, without language restrictions, up to 25 January 2016. SELECTION CRITERIA: Randomised controlled trials of progesterone, cerclage, or pessary for preventing preterm birth in women with twin pregnancies, without symptoms of threatened preterm labour...
July 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28166925/-is-universal-screening-for-cervical-length-among-singleton-pregnancies-with-no-history-of-preterm-birth-justified
#20
REVIEW
P Rozenberg
The ultrasonographic measurement of cervical length with a cutoff of 15mm is currently the best method to identify a group of asymptomatic women in the general population at risk of spontaneous preterm birth, especially among asymptomatic patients with a singleton pregnancy with no history of preterm birth. Cerclage and 17 alpha-hydroxyprogesterone caproate (17OHP-C) are ineffective to reduce the risk of preterm birth among asymptomatic patients with a short cervix in midtrimester. However, vaginal progesterone (200-mg capsules of micronized progesterone or gel containing 90mg progesterone) has been demonstrated effective in 2 large randomized trials to reduce the risk of preterm birth and possibly the composite morbidity and perinatal mortality associated among asymptomatic women with a short cervix in the general population screened by ultrasound of the cervix in midtrimester...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
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