Alternatives to the antenatal glucocorticoid treatment for the prevention of respiratory distress syndrome

Dudenhausen, Joachim W.

doi:10.1515/jpme.1987.15.5.453

Cited by 9 publications

(5 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previously, in vitro studies have shown that Am and theophylline promote relaxation in human myometrial tissue [7,9]. While in women presenting with threatened PTL, Am has been shown to be as effective as antenatal steroids for fetal lung maturation [10] and to reduce the risk of intraventricular haemorrhage in the neonate [11]. In addition, it has been used widely in extremely preterm infants to reduce the risk of apnoea [12] and bronchopulmonary dysplasia [13] and to improve neonatal outcomes in a similar way to caffeine, another cAMP-PDE inhibitor [14].…”

Section: Introductionmentioning

confidence: 99%

Aminophylline and progesterone prevent inflammation-induced preterm parturition in the mouse†

Herbert

Markovic

Georgiou

et al. 2019

Biology of Reproduction

View full text Add to dashboard Cite

Although progesterone (P4) supplementation is the most widely used therapy for the prevention of preterm labor (PTL), reports of its clinical efficacy have been conflicting. We have previously shown that the anti-inflammatory effects of P4 can be enhanced by increasing intracellular cyclic adenosine monophosphate (cAMP) levels in primary human myometrial cells. Here, we have examined whether adding aminophylline (Am), a non-specific phosphodiesterase inhibitor that increases intracellular cAMP levels, to P4 might improve its efficacy using in vivo and in vitro models of PTL. In a mouse model of lipopolysaccharide (LPS)-induced PTL, we found that the combination of P4 and Am delayed the onset of LPS-induced PTL, while the same dose of P4 and Am alone had no effect. Pup survival was not improved by either agent alone or in combination. Myometrial prolabor and inflammatory cytokine gene expression was reduced, but the reduction was similar in P4 and P4/Am treated mice. There was no effect of the combination of P4 and Am on an ex vivo assessment of myometrial contractility. In human myometrial cells and myometrial tissue explants, we found that the combination had marked anti-inflammatory effects, reducing cytokine and COX-2 mRNA and protein levels to a greater extent than either agent alone. These data suggest that the combination of P4 and Am has a more potent anti-inflammatory effect than either agent alone and may be an effective combination in women at high-risk of PTL.

show abstract

Section: Introductionmentioning

confidence: 99%

Aminophylline and progesterone prevent inflammation-induced preterm parturition in the mouse†

Herbert

Markovic

Georgiou

et al. 2019

Biology of Reproduction

View full text Add to dashboard Cite

show abstract

“…At birth, although there was reduction in the goiter size, thyroid hormone status remained low in all babies as was seen in case series by Ribault et al Levothyroxine was started in all babies which may be due to suboptimal dosing regimens and the gap between last dose of intra-amniotic LT4 and delivery. Dudenhausen 32 reported that the increase in plasma thyroid hormone levels after intraamniotic instillation of LT4 remained for only 5 days. Another factor may be due to differences in ingestion and intestinal absorption of amniotic fluid by the fetus.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis and Management of Fetal Goiter: A Case Series from Tertiary Perinatal Center in South India

Vavilala¹,

Budidapadu²,

Kolar³

2019

International Journal of Infertility &Amp; Fetal Medicine

View full text Add to dashboard Cite

Aims and objectives: The reported incidence of fetal goiter is 1 in 40,000 live births. The effects of fetal goiter and thyroid dysfunction are significant. The objective of our study is to assess the safety, feasibility, and efficacy of intra-amniotic instillation of levothyroxine (LT4) in fetal goitrous hypothyroidism. Materials and methods: A retrospective observational study of prenatally diagnosed cases of fetal goiter on routine antenatal ultrasound between January 2010 and January 2018 at Fernandez Hospital Foundation, Hyderabad, tertiary perinatal referral center. Data retrieved from electronic database. Results: During this period, 9 cases of fetal goiter were diagnosed on routine ultrasonography with the incidence of 1 in 7,000 live births. The gestation age at diagnosis ranged between 21 weeks and 29 weeks (mean 26 weeks). Of the nine fetuses with goiter, two were excluded as one ended in a miscarriage at 22 weeks and the other was terminated elsewhere at 26 weeks. Data were analyzed in the remaining seven fetuses. Cordocentesis was performed in five fetuses and amniocentesis was performed in one woman with dichorionic diamniotic (DCDA) twin gestation which revealed hypothyroid status. Fetal therapy was offered to all the remaining seven fetuses with intra-amniotic instillation of LT4 100 to 200 μg at 2-3 weeks' interval. First dose of LT4 was given at mean gestation of 27 weeks (range 23-30 weeks), and the mean time between the identification of fetal goiter and the first dose of LT4 was 6 days (range 2-15 days). Number of injections given ranged between 1 and 7. No adverse events were recorded. Follow-up sonogram showed subjective reduction in the goiter size. All the babies had hypothyroidism at birth. Conclusion: Our case series confirms the safety and feasibility of intra-amniotic instillation of LT4 for fetal goitrous hypothyroidism. Although fetal therapy has resulted in reduction in the size of the goiter, the thyroid hormone levels at birth were low. Further research is required to establish the proper management guidelines for this disorder.

show abstract

“…This 7-day injection interval is the maximum ac ceptable when the fetus is hypothyroid since Dudenhausen [20] has noted that elevated plasma T4 concentrations disappeared from the 5th day after intra-amniotic injection of 500 pg of L-T4 administered to facilitate pulmonary maturation of the fetus with a normally functioning thyroid. However Johnson et al [5] have reported an observa tion of a 39 weeks of gestation born infant.…”

Section: Discussionmentioning

confidence: 99%

“…The effect of the hormone on pulmonary maturation is rather favorable [20]. An overdose has never been described with administrations of 200-700 fig, and in fact, insufficient plasma L-T4 resulting from a too low dosage or an inter val of more than 7 days between injections is more to be feared.…”

Section: Discussionmentioning

confidence: 99%

Intrauterine Treatment of Thyroid Goiters

Sagot¹,

David²,

Yvinec³

et al. 1991

Fetal Diagn Ther

View full text Add to dashboard Cite

A fetal thyroid goiter detected by ultrasonography at 20 weeks of amenorrhea (WA) was diagnosed at 23 WA by a second ultrasound examination and a TSH assay in amniotic fluid. Since a sample of fetal blood at 27 WA showed that hypothyroidism was compensated and that goiter size and amniotic fluid volume were stable, intra-amniotic injection of 300 μg of L-thyroxine was delayed until 36 WA. This injection was performed before delivery to avoid potential perinatal complications (dystocia and neonatal respiratory distress) caused by large goiters.

show abstract

Alternatives to the antenatal glucocorticoid treatment for the prevention of respiratory distress syndrome

Cited by 9 publications

References 12 publications

Aminophylline and progesterone prevent inflammation-induced preterm parturition in the mouse†

Aminophylline and progesterone prevent inflammation-induced preterm parturition in the mouse†

Prenatal Diagnosis and Management of Fetal Goiter: A Case Series from Tertiary Perinatal Center in South India

Intrauterine Treatment of Thyroid Goiters

Contact Info

Product

Resources

About