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Progesterone in preterm birth

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https://www.readbyqxmd.com/read/27918564/interleukin-33-induced-expression-of-pibf1-by-decidual-b-cells-protects-against-preterm-labor
#1
Bihui Huang, Azure N Faucette, Michael D Pawlitz, Bo Pei, Joshua W Goyert, Jordan Zheng Zhou, Nadim G El-Hage, Jie Deng, Jason Lin, Fayi Yao, Robert S Dewar, Japnam S Jassal, Maxwell L Sandberg, Jing Dai, Montserrat Cols, Cong Shen, Lisa A Polin, Ronald A Nichols, Theodore B Jones, Martin H Bluth, Karoline S Puder, Bernard Gonik, Nihar R Nayak, Elizabeth Puscheck, Wei-Zen Wei, Andrea Cerutti, Marco Colonna, Kang Chen
Preterm birth (PTB) is a leading cause of neonatal death worldwide. Intrauterine and systemic infection and inflammation cause 30-40% of spontaneous preterm labor (PTL), which precedes PTB. Although antibody production is a major immune defense mechanism against infection, and B cell dysfunction has been implicated in pregnancy complications associated with PTL, the functions of B cells in pregnancy are not well known. We found that choriodecidua of women undergoing spontaneous PTL harbored functionally altered B cell populations...
December 5, 2016: Nature Medicine
https://www.readbyqxmd.com/read/27887710/supplementation-with-progestogens-in-the-first-trimester-of-pregnancy-to-prevent-miscarriage-in-women-with-unexplained-recurrent-miscarriage-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
Gabriele Saccone, Corina Schoen, Jason M Franasiak, Richard T Scott, Vincenzo Berghella
OBJECTIVE: To investigate whether treatment with progestogens in the first trimester of pregnancy would decrease the incidence of miscarriage in women with a history of unexplained recurrent miscarriage. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Women with a history of unexplained recurrent miscarriage. INTERVENTION(S): Randomized, controlled trials were identified by searching electronic databases...
November 22, 2016: Fertility and Sterility
https://www.readbyqxmd.com/read/27871275/rationale-and-design-of-support-a-multi-centre-randomised-controlled-trial-to-compare-three-treatments-cervical-cerclage-cervical-pessary-and-vaginal-progesterone-for-the-prevention-of-preterm-birth-in-women-who-develop-a-short-cervix
#3
Natasha L Hezelgrave, Helena A Watson, Alexandra Ridout, Falak Diab, Paul T Seed, Evonne Chin-Smith, Rachel M Tribe, Andrew H Shennan
BACKGROUND: Clinically, once a woman has been identified as being at risk of spontaneous preterm birth (sPTB) due to a short cervical length, a decision regarding prophylactic treatment must be made. Three interventions have the potential to improve outcomes: cervical cerclage (stitch), vaginal progesterone and cervical pessary. Each has been shown to have similar benefit in reduction of sPTB, but there have been no randomised control trials (RCTs) to compare them. METHODS: This open label multi-centre UK RCT trial, will evaluate whether the three interventions are equally efficacious to prevent premature birth in women who develop a short cervix (<25 mm on transvaginal ultrasound)...
November 21, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27843353/prevention-of-preterm-delivery-current-challenges-and-future-prospects
#4
REVIEW
Maud D van Zijl, Bouchra Koullali, Ben Wj Mol, Eva Pajkrt, Martijn A Oudijk
Preterm birth (PTB), defined as delivery at <37 weeks of gestation, is the most important cause of neonatal morbidity and mortality. Therefore, preventing PTB is one of the main goals in obstetric care. In this review, we provide an overview of the current available literature on screening for risk factors for PTB and a summary of preventive strategies in both low-risk and high-risk women with singleton or multiple gestations. Furthermore, current challenges and future prospects on PTB are discussed. For an optimal prevention of PTB, risk stratification should be based on a combination of (maternal) risk factors, obstetric history, and screening tools...
2016: International Journal of Women's Health
https://www.readbyqxmd.com/read/27836377/-prevention-of-spontaneous-preterm-birth-excluding-preterm-premature-rupture-of-membranes-guidelines-for-clinical-practice%C3%A2-%C3%A2-text-of-the-guidelines-short-text
#5
L Sentilhes, M-V Sénat, P-Y Ancel, E Azria, G Benoist, J Blanc, G Brabant, F Bretelle, S Brun, M Doret, C Ducroux-Schouwey, A Evrard, G Kayem, E Maisonneuve, L Marcellin, S Marret, N Mottet, S Paysant, D Riethmuller, P Rozenberg, T Schmitz, H Torchin, B Langer
OBJECTIVES: To determine the measures to prevent spontaneous preterm birth (excluding preterm premature rupture of membranes)and its consequences. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: In France, premature birth concerns 60,000 neonates every year (7.4 %), half of them are delivered after spontaneous onset of labor...
November 8, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27823998/role-of-cervical-cerclage-and-vaginal-progesterone-in-the-treatment-of-cervical-incompetence-with-without-preterm-birth-history
#6
Shao-Wei Wang, Lin-Lin Ma, Shuai Huang, Lin Liang, Jun-Rong Zhang
BACKGROUND: Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality worldwide, and its prevention is an important health-care priority. The cervical incompetence is a well-known risk factor for PTB and its incidence is about 0.1-2.0%, while there is no ideal optimum treatment recommended currently. The cervical incompetence causes about 15% of habitual abortion in 16-28 weeks. This study aimed to evaluate the effectiveness and safety of cervical cerclage and vaginal progesterone in the treatment of cervical incompetence with/without PTB history...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27813278/universal-cervical-length-screening-for-singleton-pregnancies-with-no-history-of-preterm-delivery-or-the-inverse-of-the-pareto-principle
#7
REVIEW
P Rozenberg
: Ultrasound measurement of cervical length in the general population enables the identification of women at risk for spontaneous preterm delivery. Vaginal progesterone is effective in reducing the risk of preterm delivery in this population. This screening associated with treatment by vaginal progesterone is cost-effective. Universal screening of cervical length can therefore be considered justified. Nonetheless, this screening will not appreciably reduce the preterm birth prevalence: in France or UK, where the preterm delivery rate is around 7...
November 4, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27776845/-the-use-of-progestatives-for-the-prevention-of-spontaneous-preterm-birth
#8
E Azria
OBJECTIVES: To identify clinical situations in which progestatives used to reduce the risk of spontaneous preterm delivery and/or reduced adverse neonatal outcomes have been evaluated and identify situations in which 17OHPC or vaginal progesterone might be recommended. METHODS: Bibliographic searches were performed in the Medline and Cochrane databases with the use of a combination of keywords and text words related to "progesterone", "tocolysis", and "preterm labor" from 1956 through July 2016...
October 21, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27775195/17-alpha-hydroxyprogesterone-caproate-versus-vaginal-progesterone-suppository-for-the-prevention-of-preterm-birth-in-women-with-a-sonographically-short-cervix-a-randomized-controlled-trial
#9
Reihaneh Pirjani, Reza Heidari, Abbas Rahimi-Foroushani, Seyedehsara Bayesh, Arezoo Esmailzadeh
AIM: The aim of this study was to compare 17-alpha-hydroxyprogesterone caproate (17OHP-C) with vaginal progesterone suppository for the prevention of preterm birth in women with a sonographically short cervix and to evaluate the changes of the cervical length (CL) over time. METHODS: In this prospective randomized controlled trial, eligible patients were asymptomatic pregnant women with a sonographically short cervix. The participants in group 1 (n = 147) received vaginal progesterone suppositories at a dose of 400 mg daily and the women in group 2 (n = 150) received an i...
October 24, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27764015/progesterone-as-a-tocolytic-agent-for-preterm-labor-a-systematic-review
#10
Reshama Navathe, Vincenzo Berghella
PURPOSE OF REVIEW: Tocolytic agents have been used for over 60 years in the fight against preterm labor, which ultimately can lead to preterm birth. Currently, clinicians can choose from a variety of drug classes to achieve the primary goal of delaying delivery by 48 h, thereby allowing time for administration of corticosteroids for fetal lung maturity, and if appropriate, starting magnesium sulfate for fetal neuroprotection. However, there are currently no known therapies to maintain the tocolytic effect beyond those initial 48 h...
December 2016: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27741176/pregnancy-outcomes-in-women-with-a-history-of-previable-preterm-prelabor-rupture-of-membranes
#11
Martha A Monson, Karen J Gibbons, M Sean Esplin, Michael W Varner, Tracy A Manuck
OBJECTIVE: To characterize subsequent pregnancy outcomes among women with a history of previable, preterm prelabor rupture of membranes (PROM) and assess factors associated with recurrent preterm birth. METHODS: This was a retrospective cohort study of women cared for with a history of one or more singleton pregnancy complicated by preterm PROM at less than 24 weeks of gestation between 2002 and 2013 who were cared for in two tertiary care health systems by a single group of maternal-fetal medicine specialists...
November 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27718280/combined-treatment-with-cervical-pessary-and-vaginal-progesterone-for-the-prevention-of-preterm-birth-a-randomized-clinical-trial
#12
Niloofar Karbasian, Mahdi Sheikh, Reihaneh Pirjani, Shahla Hazrati, Fatemeh Tara, Sedigheh Hantoushzadeh
AIM: We compared the effectiveness of a combined treatment involving cervical pessary plus vaginal progesterone to vaginal progesterone alone in decreasing the rate of preterm birth in women with short cervix in the second gestational trimester. METHODS: This prospective, open-label, randomized clinical trial was conducted on 144 pregnant women with singleton pregnancy who had a cervical length ≤ 25 mm, at 18-22 gestational weeks (GW). Seventy-three patients were assigned to receive 400 mg of daily vaginal progesterone (group A), and 73 to receive cervical pessary plus 400 mg of daily vaginal progesterone (group B), until the 37th GW...
October 8, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27662646/progesterone-in-normal-and-pathological-pregnancy
#13
Gian Carlo Di Renzo, Irene Giardina, Graziano Clerici, Eleonora Brillo, Sandro Gerli
Progesterone is an essential hormone in the process of reproduction. It is involved in the menstrual cycle, implantation and is essential for pregnancy maintenance. It has been proposed and extensively used in the treatment of different gynecological pathologies as well as in assisted reproductive technologies and in the maintenance of pregnancy. Called "the pregnancy hormone", natural progesterone is essential before pregnancy and has a crucial role in its maintenance based on different mechanisms such as: modulation of maternal immune response and suppression of inflammatory response (the presence of progesterone and its interaction with progesterone receptors at the decidua level appears to play a major role in the maternal defense strategy), reduction of uterine contractility (adequate progesterone concentrations in myometrium are able to counteract prostaglandin stimulatory activity as well as oxytocin), improvement of utero-placental circulation and luteal phase support (it has been demonstrated that progesterone may promote the invasion of extravillous trophoblasts to the decidua by inhibiting apoptosis of extravillous trophoblasts)...
July 1, 2016: Hormone Molecular Biology and Clinical Investigation
https://www.readbyqxmd.com/read/27641755/addition-of-adjuvant-progesterone-to-physical-exam-indicated-cervical-cerclage-to-prevent-preterm-birth
#14
Eun Young Jung, Kyung Joon Oh, Joon-Seok Hong, Bo Ryoung Han, Jung Kyung Joo
AIM: The aim of this study was to assess the effect of vaginal progesterone as an adjuvant therapy to physical-exam-indicated cervical cerclage (PEICC). METHODS: This retrospective cohort study included 53 consecutive singleton women who underwent PEICC because of acute cervical insufficiency at 17-24 gestational weeks. The study population was divided into two groups: the adjuvant progesterone group (n = 18) and the non-adjuvant group (n = 35). A 200-mg dose of vaginal micronized natural progesterone was administered after cerclage in the adjuvant progesterone group...
September 19, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27629593/fetal-to-maternal-signaling-in-the-timing-of-birth
#15
Carole R Mendelson, Alina P Montalbano, Lu Gao
Preterm birth remains the major cause of neonatal morbidity and mortality throughout the world. This is due, in part, to our incomplete understanding of the mechanisms that underlie the maintenance of pregnancy and the initiation of parturition at term. In this article, we review our current knowledge of the complex, interrelated and concerted mechanisms whereby progesterone maintains myometrial quiescence throughout most of pregnancy, as well as those that mediate the upregulation of the inflammatory response and decline in progesterone receptor function leading to parturition...
September 11, 2016: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/27626455/increasing-incidence-rate-of-cervical-cerclage-in-pregnancy-in-australia-a-population-based-study
#16
Corrine Lu, Boon Lim, Stephen J Robson
OBJECTIVE: Data published from the United States have demonstrated that the use of cervical cerclage has fallen in the period 1998-2013. This is in contrast to recommendations in Australia. We examined this trend using data from the Australian Institute of Health and Welfare (AIHW). STUDY DESIGN: Retrospective population-based study. METHODS: Data from the Australian Institute of Health and Welfare procedural database were used to determine the total number of cervical cerclage sutures inserted during the period 2004 to 2013...
September 12, 2016: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/27623283/is-routine-transvaginal-cervical-length-measurement-cost-effective-in-a-population-where-the-risk-of-spontaneous-preterm-birth-is-low
#17
David A Crosby, Jan Miletin, Jana Semberova, Sean Daly
INTRODUCTION: A recent meta-analysis has suggested that routine measurement of the cervical length should be performed in conjunction with the anomaly scan to identify a group of women at increased risk of preterm delivery. We decided to investigate whether this recommendation is justifiable in a population where the risk of preterm birth is low. MATERIAL AND METHODS: We reviewed 12 years of obstetric data from the Coombe Women and Infants University Hospital. Relative risks of adverse outcomes from the randomized controlled trial were applied and we extrapolated the possible numbers of women requiring intervention...
September 13, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27600865/the-prevalence-of-short-cervix-between-20-and-24-weeks-of-gestation-and-vaginal-progesterone-for-prolonging-of-gestation
#18
Malipati Maerdan, Chunyan Shi, Xiaoxiao Zhang, Lixin Fan
OBJECTIVE: The objective of this study is to understand the prevalence of short cervical length between 20 and 24 weeks gestation in China and to evaluate the efficacy of micronized progesterone for prolonging gestation in nulliparous patients with a short cervix. METHODS: From May 2010 to May 2015, a total of 25 328 asymptomatic women with singleton pregnancies at Peking University First Hospital had their cervical length routinely measured between 20 and 24 weeks of gestation...
September 7, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27568524/systematic-review-of-the-association-between-oil-and-natural-gas-extraction-processes-and-human-reproduction
#19
REVIEW
Victoria D Balise, Chun-Xia Meng, Jennifer N Cornelius-Green, Christopher D Kassotis, Rana Kennedy, Susan C Nagel
This systematic review identified 45 original published research articles related to oil and gas extraction activities and human reproductive endpoints. Reproductive outcomes were categorized as [1] birth outcomes associated with maternal exposure, [2] semen quality, fertility, and birth outcomes associated with adult paternal exposure, [3] reproductive cancers, and [4] disruption of human sex steroid hormone receptors. The results indicate there is moderate evidence for an increased risk of preterm birth, miscarriage, birth defects, decreased semen quality, and prostate cancer...
September 15, 2016: Fertility and Sterility
https://www.readbyqxmd.com/read/27556454/the-effects-of-female-sexual-hormones-on-the-expression-of-aquaporin-5-in-the-late-pregnant-rat-uterus
#20
Adrienn Csányi, Judit Bóta, George Falkay, Robert Gáspár, Eszter Ducza
Thirteen mammalian aquaporin (AQP) water channels are known, and few of them play a role in the mammalian reproductive system. In our earlier study, the predominance of AQP5 in the late-pregnant rat uterus was proven. Our current aim was to investigate the effect of estrogen- and gestagen-related compounds on the expression of the AQP5 channel in the late-pregnant rat uterus. Furthermore, we examined the effect of hormonally-induced preterm delivery on the expression of AQP5 in the uterus. We treated pregnant Sprague-Dawley rats subcutaneously with 17β-estradiol, clomiphene citrate, tamoxifen citrate, progesterone, levonorgestrel, and medroxyprogesterone acetate...
2016: International Journal of Molecular Sciences
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