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Progesterone in preterm birth

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https://www.readbyqxmd.com/read/28798414/comparison-of-neonatal-outcomes-following-progesterone-use-during-ovarian-stimulation-with-frozen-thawed-embryo-transfer
#1
Xiuxian Zhu, Hongjuan Ye, Yonglun Fu
Progesterone soft capsules (brand name: Utrogestan) were demonstrated to be an effective oral alternative to prevent premature LH surges both in normal-ovulatory and polycystic ovarian syndrome (PCOS) patients. However, its safety in terms of neonatal outcomes is unclear. To evaluate whether Utrogestan use increase the risk of adverse neonatal outcomes compared with short protocol in patients undergoing IVF/ICSI treatments in combination with frozen-thawed embryo transfer (FET), we performed a retrospective analysis including 1008 FET cycles, with embryos originated from either Utrogestan + hMG protocol (n = 499), or short protocol (n = 509), which led to 546 live-born infants...
August 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28791263/second-trimester-cervical-length-measurement-for-prediction-spontaneous-preterm-birth-in-an-unselected-risk-population
#2
Alberto Borges Peixoto, Taciana Mara Rodrigues da Cunha Caldas, Luisa Almeida Tahan, Caetano Galvão Petrini, Wellington P Martins, Fabricio Da Silva Costa, Edward Araujo Júnior
OBJECTIVE: To assess the predictive capacity of cervical length (CL) measurement underwent during the second trimester ultrasound for prediction preterm birth <32, 34, and 37 weeks of gestation in an unselected risk population. METHODS: A retrospective cohort study was performed with 751 singleton pregnancies between 20 and 24+6 weeks of gestation. The CL measurement (mm) using the transvaginal route was obtained in a sagittal view and the calipers positioned to measure the linear distance between the triangular area of echodensity at the external os and the internal os...
July 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28777967/optimal-routes-of-administration-vehicles-and-timing-of-progesterone-treatment-for-inhibition-of-delivery-during-pregnancy
#3
Dajun Fang, Mario Moreno, Robert E Garfield, Ruben Kuon, Huimin Xia
OBJECTIVES: Progestins, notably progesterone (P4) and 17 alpha hydroxyprogesterone caproate, are presently used to treat pregnant women at risk of preterm birth. The aim of this study was to assess the optimal treatment options for progesterone (P4) to delay delivery using a sensitive bioassay for progesterone. STUDY DESIGN: Pregnant rats, known to be highly sensitive to progestins, were treated with P4, including Prochieve(®) (also known as Crinone(®)), in various vehicles from day 13 of gestation and in late gestation, days 19 to 22, and delivery times noted...
June 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28768474/progesterone-in-women-with-arrested-premature-labor-a-report-of-a-randomised-clinical-trial-and-updated-meta-analysis
#4
Stephen Wood, Yacov Rabi, Selphee Tang, Rollin Brant, Susan Ross
BACKGROUND: Progesterone may be effective in prevention of premature birth in some high risk populations. Women with arrested premature labor are at risk of recurrent labor and maintenance therapy with standard tocolytics has not been successful. METHODS: Randomized double blinded clinical trial of daily treatment with 200 mg vaginal progesterone in women with arrested premature labor and an updated meta-analysis. RESULTS: The clinical trial was terminated early after 41 women were enrolled...
August 2, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28762599/diversity-of-progesterone-action-on-lipopolysaccharide-induced-expression-changes-in-cultured-human-cervical-fibroblasts-according-to-inflammation-and-treatment-timing
#5
Yoshimitsu Kuwabara, Akira Katayama, Sachiko Kurihara, Marie Ito, Mirei Yonezawa, Nozomi Ouchi, Ryuhei Kurashina, Tomoko Ichikawa, Rintaro Sawa, Akihito Nakai, Hideo Orimo, Toshiyuki Takeshita
PROBLEM: The effectiveness of progesterone (P4) treatment for preventing preterm births is unclear. Its effects on the uterine cervix were tested using cultured human uterine cervical fibroblasts (UCFs). METHOD OF STUDY: UCFs were incubated with lipopolysaccharide (LPS) in the presence or absence of P4 under various conditions. mRNA was subjected to PCR arrays and real-time RT-PCR to assess IL-6, IL-8, IL-1beta, PTGS2, MMP-1, and CXCL10 expression. RESULTS: When exposed to a high-LPS concentration (2...
August 1, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/28754971/in-vivo-raman-spectral-analysis-of-impaired-cervical-remodeling-in-a-mouse-model-of-delayed-parturition
#6
Christine M O'Brien, Jennifer L Herington, Naoko Brown, Isaac J Pence, Bibhash C Paria, James C Slaughter, Jeff Reese, Anita Mahadevan-Jansen
Monitoring cervical structure and composition during pregnancy has high potential for prediction of preterm birth (PTB), a problem affecting 15 million newborns annually. We use in vivo Raman spectroscopy, a label-free, light-based method that provides a molecular fingerprint to non-invasively investigate normal and impaired cervical remodeling. Prostaglandins stimulate uterine contractions and are clinically used for cervical ripening during pregnancy. Deletion of cyclooxygenase-1 (Cox-1), an enzyme involved in production of these prostaglandins, results in delayed parturition in mice...
July 28, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28753545/adjuvant-administration-of-17-%C3%AE-hydroxy-progesterone-caproate-in-women-with-three-or-more-second-trimester-pregnancy-losses-undergoing-cervical-cerclage-is-no-more-effective-than-cerclage-alone
#7
Fernand D Samson, Amanda L Merriman, Danielle L Tate, Katherine Apostolakis-Kyrus, Luis M Gomez
OBJECTIVE: To investigate the role of adjuvant 17-α-hydroxy-progesterone caproate (17OHP-C) in reducing the risk of preterm delivery <34 weeks and adverse perinatal outcomes in women with ≥3 second trimester pregnancy losses attributed to cervical insufficiency undergoing prophylactic cerclage. MATERIAL AND METHODS: Retrospective cohort study of women with prophylactic cerclage placed between 2006 and 2014 divided into a cohort of (i) those receiving adjuvant 17OHP-C (n=43), and (ii) controls with cerclage alone (n=59)...
July 28, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28747362/alterations-of-adrenal-steroidomic-profiles-in-preterm-infants-at-birth
#8
Simon Travers, Laetitia Martinerie, Pascal Boileau, Marc Lombès, Eric Pussard
OBJECTIVE: Preterm infants have relative adrenal and kidney immaturity. Recently, we linked their urine sodium loss to a hypoaldosteronism at variance with an appropriate stimulation of the renin-angiotensin system. To investigate this defective aldosterone secretion, we analyse the biosynthesis pathways of adrenal steroids in neonates according to gestational age (GA). DESIGN: Multicentre study (Premaldo) including 152 neonates classified into three groups: group 1 (very preterm (VPT)): <33 ‰gestational weeks (GW); group 2 (preterm (PT)): 33-36 GW and group 3 (term (T)): ≥37 GW...
July 26, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28742594/cervical-evaluation-in-pregnancy-proper-measurement-evaluation-and-management
#9
Joseph R Wax, Angelina Cartin, Michael G Pinette
Preterm birth is the leading cause of perinatal morbidity and mortality in developed nations. The heterogeneous causes of spontaneous preterm birth make prediction and prevention difficult. The primary importance of transvaginal cervical sonography and cervicovaginal fetal fibronectin lies in their high negative predictive values in assessing risk for preterm birth. Cervical length may be useful in identifying women who are candidates for cervical cerclage or progesterone therapy for preterm birth prevention...
September 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28731465/pr-set7-deficiency-limits-uterine-epithelial-population-growth-hampering-postnatal-gland-formation-in-mice
#10
Tongtong Cui, Bo He, Shuangbo Kong, Chan Zhou, Hangxiao Zhang, Zhangli Ni, Haili Bao, Jingtao Qiu, Qiliang Xin, Danny Reinberg, John P Lydon, Jinhua Lu, Haibin Wang
Formation of secretary endometrial glands in the uterus known as adenogenesis is a typical process of branching morphogenesis involving dynamic epithelial growth and differentiation. Unsuccessful adenogenesis often leads to female infertility. However, it remains largely unexplored so far regarding the epigenetic machinery governing normal endometrial gland formation. Here, we demonstrated that PR-Set7, an epigenetic regulator for H4K20me1 modification, was extensively expressed in the postnatal uteri, and its conditional deletion resulted in a complete lack of endometrial glands and infertility in mice...
July 21, 2017: Cell Death and Differentiation
https://www.readbyqxmd.com/read/28729911/vaginal-progesterone-to-reduce-preterm-birth-among-hiv-infected-pregnant-women-in-zambia-a-feasibility-study-protocol
#11
Joan T Price, Katie R Mollan, Nurain M Fuseini, Bethany L Freeman, Helen B Mulenga, Amanda H Corbett, Bellington Vwalika, Jeffrey S A Stringer
BACKGROUND: Women infected with HIV have a risk of preterm birth (PTB) that is twice that among uninfected women, and treatment with antiretroviral therapy (ART) may further increase this risk. Progesterone supplementation reduces the risk of preterm delivery in women who have a shortened cervix in the midtrimester. We propose to study the feasibility of a trial of vaginal progesterone (VP) to prevent PTB among HIV-infected women receiving ART in pregnancy. Given low adherence among women self-administering vaginal study product in recent microbicide trials, we plan to investigate whether adequate adherence to VP can be achieved prior to launching a full-scale efficacy trial...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28687440/variation-in-coverage-for-progesterone-to-prevent-preterm-birth-a-survey-of-medicaid-managed-care-organizations
#12
Priya Batra, Ashley A Hernandez Gray, Jennifer E Moore
INTRODUCTION: Preterm birth is the leading cause of U.S. infant morbidity and mortality; Medicaid enrollees disproportionately experience preterm deliveries. Data suggest that progesterone-an evidence-based therapy for preventing preterm birth-is not accessible to all eligible Medicaid beneficiaries. This study aimed to identify variation in progesterone coverage guidelines in a sample of state Medicaid managed care organizations (MMCOs). MATERIAL AND METHODS: Using a cross-sectional design, participation in a web-based survey was offered to 20 MMCO members of the Medicaid Health Plans of America...
July 4, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28667298/evolution-of-gene-expression-in-the-uterine-cervix-related-to-steroid-signaling-conserved-features-in-the-regulation-of-cervical-ripening
#13
Günter P Wagner, Mauris C Nnamani, Arun Rajendra Chavan, Jamie Maziarz, Stella Protopapas, Jennifer Condon, Roberto Romero
The uterine cervix is the boundary structure between the uterus and the vagina and is key for the maintenance of pregnancy and timing of parturition. Here we report on a comparative transcriptomic study of the cervix of four placental mammals, mouse, guinea pig, rabbit and armadillo, and one marsupial, opossum. Our aim is to investigate the evolution of cervical gene expression as related to putative mechanisms for functional progesterone withdrawal. Our findings are: 1) The patterns of gene expression in eutherian (placental) mammals are consistent with the notion that an increase in the E/P4 signaling ratio is critical for cervical ripening...
June 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28594783/progestogens-for-maintenance-tocolysis-in-women-with-a-short-cervix-a-randomized-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
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)...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28586127/cervical-stitch-cerclage-for-preventing-preterm-birth-in-singleton-pregnancy
#15
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
#16
Ivo Brosens, Joanne Muter, Caroline E 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
#17
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%C3%A2-birth
#18
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. Nonculture 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
#19
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
#20
Martha L Bustos, Steve N Caritis, Kathleen A Jablonski, Uma M Reddy, Yoram Sorokin, Tracy Manuck, 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
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