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Guillaume Ducarme, François Desroys du Roure, Aurélie Le Thuaut, Joséphine Grange, Mathilde Vital, Jérôme Dimet
BACKGROUND: A hypothesis of preterm parturition is that the pathogenesis of spontaneous preterm birth (sPTB) may be associated with an inflammatory process. Based on this theory, we have hypothesized that an inflammatory biomarker, procalcitonin (PCT), may be a good predictive marker of sPTB at the admission for threatened preterm labour (TPL). The present study was aimed to investigate the association between serum PCT and sPTB in women with TPL and to evaluate whether PCT levels may predict sPTB in women with TPL within 7 or 14 days...
March 7, 2018: BMC Pregnancy and Childbirth
Jennifer Danielsson, Joy Vink, Shunsuke Hyuga, Xiao Wen Fu, Hiromi Funayama, Ronald Wapner, Andrew M Blanks, George Gallos
BACKGROUND: Spontaneous preterm labor leading to preterm birth is a significant obstetric problem leading to neonatal morbidity and mortality. Current tocolytics are not completely effective and novel targets may afford a therapeutic benefit. OBJECTIVE: To determine whether the anoctamin (ANO) family, including the calcium-activated chloride channel ANO1, is present in pregnant human uterine smooth muscle (USM) and whether pharmacological and genetic modulation of ANO1 modulates USM contraction...
January 1, 2018: Reproductive Sciences
Nancy Medley, Borna Poljak, Silvia Mammarella, Zarko Alfirevic
BACKGROUND: Clinical practice guidelines (CPG) endorse multiple strategies to prevent or manage preterm birth (PTB). OBJECTIVES: To summarise CPG recommendations for PTB and identify areas of international consensus. SEARCH STRATEGY: In June 2017 we searched for all CPG relavant to PTB without language restrictions. SELECTION CRITERIA: CPG were eligible if the following criteria were met. i.The guideline was published or current from June 2013...
February 20, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
Kaouther Dimassi, Ines Bouriel, Amel Triki, Ali Mrabet, Mohamed Faouzi Gara
BACKGROUND: Preterm delivery is the major cause of adverse outcomes in twin pregnancy.  A shortened cervix at 20-24 weeks of amenorrhea is a good predictor of preterm birth in asymptomatic patients. However, there are no recommendations for serial cervical length measurements for these high risk pregnancies. OBJECTIVES: To evaluate the benefits from monthly cervical length monitoring in asymptomatic twin pregnancies. METHODS: This was a prospective study...
March 2017: La Tunisie Médicale
Kenichi Tanaka, Hiroko Mori, Rieko Sakamoto, Shirou Matsumoto, Hiroshi Mitsubuchi, Kimitoshi Nakamura, Masanori Iwai
BACKGROUND: Neonatal nonoliguric hyperkalemia (NOHK) is a metabolic abnormality that occurs in extremely premature neonates at approximately 24 h after birth and is mainly due to the immature functioning of the sodium (Na + )/potassium (K + ) pump. Magnesium sulfate is frequently used in obstetrical practice to prevent preterm labor and to treat preeclampsia; this medication can also cause hypermagnesemia and hyperkalemia by a mechanism that is different from that of NOHK. Herein, we report the first case of very early-onset neonatal hyperkalemia induced by maternal hypermagnesemia...
February 13, 2018: BMC Pediatrics
Homeira Vafaei, Neda Rahimirad, Seyedeh Marjan Hosseini, Maryam Kasraeian, Nasrin Asadi, Hadi Raeisi Shahraki, Khadijeh Bazrafshan
Background: Preterm labor and birth are associated with several neonatal complications including respiratory distress syndrome and intraventricular hemorrhage. Differentiating true and false labor pain is a dilemma to obstetricians. Objective: To elucidate the role of cervical length measurement in prediction of birth in pregnant women with threatened preterm labor. Materials and Methods: In this double blind randomized clinical trial, 120 women with gestational age <34 wk who presented painful uterine contractions randomly assigned to undergo measurement of cervical length...
November 2017: International Journal of Reproductive Biomedicine (Yazd, Iran)
Miha Lucovnik, Andreja Trojner Bregar, Lea Bombac, Ksenija Gersak, Robert E Garfield
AIM: The effectiveness of vaginal progesterone for maintenance tocolysis after arrested preterm labor remains controversial. Myometrial contractility can be assessed objectively and non-invasively after progesterone treatment by monitoring uterine electromyography (EMG). We examined the effects of vaginal progesterone on uterine EMG after successful acute tocolysis. METHODS: This was a randomized, double-blind, single-center study performed between 2012 and 2015...
January 3, 2018: Journal of Obstetrics and Gynaecology Research
Satoshi Shinohara, Rei Sunami, Yuzo Uchida, Shuji Hirata, Kohta Suzuki
OBJECTIVE: Pulmonary oedema is recognised as a severe side effect of ritodrine hydrochloride. Recently, the number of twin pregnancies has been increasing. Few studies have reported the association between total dose of ritodrine hydrochloride prior to delivery and pulmonary oedema in twin pregnancy. We aimed to examine this association and determine the optimal cut-off threshold of total ritodrine hydrochloride dose to predict the incidence of pulmonary oedema in twin pregnancy based on obstetric records...
December 29, 2017: BMJ Open
Satoshi Yoneda, Noriko Yoneda, Kaori Fukuta, Tomoko Shima, Akitoshi Nakashima, Arihiro Shiozaki, Osamu Yoshino, Mika Kigawa, Taketoshi Yoshida, Shigeru Saito
AIM: We evaluated whether maintenance tocolysis (intravenous ritodrine hydrochloride and/or magnesium sulfate) was effective in cases of spontaneous preterm labor with intact membranes. METHODS: One hundred and thirty preterm labor patients who reached 36 weeks of gestation by maintenance tocolysis were selected. Immediate delivery (ID) after ceasing maintenance tocolysis was defined as an 'effective case'. The correlated factors between ID and no immediate delivery (NID) were statistically analyzed...
December 14, 2017: Journal of Obstetrics and Gynaecology Research
Joshua D Younger, Elena Reitman, George Gallos
In the United States, the generally accepted indication for tocolytic therapy centers on suppression of preterm labor. This may be in the form of preventative therapy with progesterone in women with prior spontaneous preterm birth or as an acute intervention to suppress established uterine contractions associated with cervical change occurring at less than 37 weeks gestation. This article seeks to apply this perspective to tocolytic therapy. Here, we provide a review of current tocolytic options and what the last decade of discovery has revealed about the regulation of myometrial excitability and quiescence...
December 2017: Seminars in Perinatology
Vipin Sharma, Sooraj V Nair, Pooja Jaitley, Udayraj P Nakade, Abhishek Sharma, Soumen Choudhury, Satish Kumar Garg
Cellular coupling of beta3 -adrenoceptors (β3 -ADR) to potassium channels in myometrium is largely unknown. In vitro study was undertaken to unravel the presence of β3 -adrenergic receptors (ADR) and the role of K+ -channels in mediating β3 -ADR-induced relaxation in isolated myometrial strips from cyclic non-pregnant water buffaloes. Isometric tension was recorded in isolated myometrial strips using data acquisition system based physiograph. Compared to SR 59230A, BRL 37344 was found to be more potent in inducing β3 -dependent myometrial relaxation which was significantly (p < 0...
February 2018: Theriogenology
Mengühan Araz Altay, Işık Görker, Rakhshanda Aslanova, Leyla Bozatlı, Nesrin Turan, Petek Balkanlı Kaplan
AIM: To investigate whether maternal intravenous beta-mimetic tocolytic therapy increases the risk of autistic spectrum disorders (ASD) and poorer behavioural and developmental outcomes. METHOD: Our study is a prospective case-control study among 90 children between 1.5 and three years old. Cases (n = 46) were toddlers with betamimetic tocolytic exposure; control group toddlers (n = 44) were tocolytic untreated. Treated and untreated groups were also divided into subgroups: term and preterm delivered...
October 15, 2017: Open Access Macedonian Journal of Medical Sciences
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...
December 2017: Acta Obstetricia et Gynecologica Scandinavica
Isabelle Dehaene, Lina Bergman, Paula Turtiainen, Alexandra Ridout, Ben Willem Mol, Elsa Lorthe
It is inherent to human logic that both doctors and patients want to suppress uterine contractions when a woman presents in threatened preterm labor. Tocolysis is widely applied in women with threatened preterm labor with a variety of drugs. According to literature, tocolysis is indicated to enable transfer to a tertiary center as well as to ensure the administration of corticosteroids for fetal maturation. There is international discrepancy in the content and the implementation of guidelines on preterm labor...
December 2017: Seminars in Perinatology
Nicole Ochsenbein-Kölble, Franziska Krähenmann, Margret Hüsler, Martin Meuli, Ueli Moehrlen, Lucca Mazzone, Peter Biro, Roland Zimmermann
INTRODUCTION: To compare tocolysis with magnesium sulfate versus atosiban regarding the occurrence of short-term preterm labor and maternal side effects during and after open fetal myelomeningocele (MMC) repair. MATERIAL AND METHODS: A prospective nonrandomized cohort study was performed including 30 fetal MMC cases. The first 15 cases (group 1) received magnesium sulfate according to the MOMS protocol. In the following 15 cases (group 2), magnesium sulfate was substituted by atosiban...
August 17, 2017: Fetal Diagnosis and Therapy
Wagner R Hernandez, Rossana P V Francisco, Roberto E Bittar, Ursula T Gomez, Marcelo Zugaib, Maria L Brizot
AIM: Our aim was to investigate the effect of the prophylactic use of vaginal progesterone on the latency period from the initiation of tocolytic therapy to delivery in twin pregnancies with preterm labor. METHODS: This study was a secondary analysis of a randomized, double-blind, placebo-controlled trial of twin pregnancies in mothers who were exposed to a 200 mg vaginal progesterone ovule or a placebo ovule daily from 18 to 34 weeks gestation. Patients who were administered tocolysis with Atosiban because of preterm labor were included...
July 14, 2017: Journal of Obstetrics and Gynaecology Research
Moritz Döbert, Aleke Brandstetter, Wolfgang Henrich, Tamina Rawnaq, Hendrik Hasselbeck, Timm Fabian Döbert, Larry Hinkson, Peter Schwaerzler
AIM: To compare the efficacy and safety of the misoprostol vaginal insert (MVI) with an off-label use of oral misoprostol (OM). METHODS: Pair-matched case-control study comparing the induction of labor with a retrievable MVI to OM. The primary outcomes were the time from induction to delivery and the cesarean section rate. Secondary outcomes included uterine tachysystole, tocolysis, fetal scalp blood testing, meconium-stained amniotic fluid, umbilical arterial pH, and Apgar score...
June 26, 2017: Journal of Perinatal Medicine
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
Philipp Wagner, Jiri Sonek, Harald Abele, Loefler Sarah, Markus Hoopmann, Sara Brucker, Qinging Wu, Karl Oliver Kagan
OBJECTIVE: To compare the effectiveness of contemporary treatment of preterm labor to a historical cohort. STUDY DESIGN: Retrospective matched case-control study to compare the outcomes of patients that were treated for preterm labor at the University Hospital of Tuebingen, Germany in 2014/2015 (current treatment cohort) and 2006/2007 (historical cohort). The study included women with singleton gestations who were admitted with the diagnosis of preterm labor between 24 + 0 and 34 + 0 weeks' gestation and a cervical length of ≤15 mm...
July 2017: Archives of Gynecology and Obstetrics
Elsa Lorthe, François Goffinet, Stéphane Marret, Christophe Vayssiere, Cyril Flamant, Mathilde Quere, Valérie Benhammou, Pierre-Yves Ancel, Gilles Kayem
BACKGROUND: There are conflicting results regarding tocolysis in cases of preterm premature rupture of membranes. Delaying delivery may reduce neonatal morbidity because of prematurity and allow for prenatal corticosteroids and, if necessary, in utero transfer. However, that may increase the risks of maternofetal infection and its adverse consequences. OBJECTIVE: The objective of the study was to investigate whether tocolytic therapy in cases of preterm premature rupture of membranes is associated with improved neonatal or obstetric outcomes...
August 2017: American Journal of Obstetrics and Gynecology
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