Cervical length changes during preterm cervical ripening: effects of 17-α-hydroxyprogesterone caproate

Facchinetti, Fabio; Paganelli, Simone; Comitini, Giuseppina; Dante, Giulia; Volpe, Annibale

doi:10.1016/j.ajog.2006.09.009

Cited by 142 publications

(127 citation statements)

References 23 publications

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“…(63) In 188 women with singleton gestations still pregnant after successful tocolysis for PTL, 17P 500mg IM twice weekly started at 24-31 6/7 weeks until 36 weeks was associated with similar incidences of PTB <37, <34, and <32 weeks, and of perinatal morbidity and mortality compared to no such treatment (64)…”

Section: Pmentioning

confidence: 99%

Progesterone and preterm birth prevention: translating clinical trials data into clinical practice

Berghella¹

2012

American Journal of Obstetrics and Gynecology

294

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Section: Pmentioning

confidence: 99%

Progesterone and preterm birth prevention: translating clinical trials data into clinical practice

Berghella¹

2012

American Journal of Obstetrics and Gynecology

294

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“…[19][20][21][22][23][24][25][26][27][28][29][30] But there are few studies regarding role of progesterone in threatened PTL. [34][35][36][37][38][39] Most of the studies compared the effect of progesterone as a maintainance tocolytic with placebo after initial tocolysis with other agents. There are very few studies compairing the different routes of use of progeterone.…”

Section: Results and Analysismentioning

confidence: 99%

Comparative Study to Assess the Efficacy Between Intramuscular and Vaginal Micronized Progesterone to Prevent Threatened Premature Labour

Patra¹,

Chattopadhyay²,

Munsi³

et al. 2015

jemds

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Preterm birth remains a major clinical problem. Prematurity is not only a major cause of perinatal mortality but also leads to greater risk for short and long term complications including disability and impediments in growth and mental development. To compare vaginal with intramuscular progesterone administration to prevent preterm labor and to detect the effect of both on the uterine and foetal circulations. STUDY DESIGN: comparative interventional study. POPULATION: 100 pregnant women attending NRSMCH Kolkata, Obstetrics emergency with threatened preterm labour before 34 weeks of gestation. STUDY PERIOD: one year. METHODS: Gestational age was confirmed clinically and by USG of early weeks of gestation. Efficacy and tolerability of progesterone in two routes i.e., intramuscular and vaginal for prevention of threatened preterm labour were compared. OUTCOME: Ante partum, intrapartum and perinatal outcomes were compared between two groups by statistical analysis of data's using chi-square test and student-t test. CONCLUSION: Vaginal progesterone was as effective as intramuscular progesterone in reducing preterm birth with fewer side effects in favor of vaginal route.

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“…Because only 1 small study has reported outcomes in women with arrested preterm labor treated with 17P, use in these women is not currently recommended. 70 ○ Should 17P be used in women with a prior preterm birth followed by a term birth without any type of treatment who is now presenting in a third (or later) pregnancy? This question has not been directly addressed in the literature.…”

Section: Interventions To Reduce the Risk Of Recurrent Preterm Birthmentioning

confidence: 99%

Care for Women with Prior Preterm Birth

Iams

2010

Preterm Birth

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Women who have delivered an infant between 16 and 36 weeks' gestation have an increased risk of preterm birth in subsequent pregnancies. The risk increases with more than 1 preterm birth and is inversely proportional to the gestational age of the previous preterm birth. African American women have rates of recurrent preterm birth that are nearly twice that of women of other backgrounds. An approximate risk of recurrent preterm birth can be estimated by a comprehensive reproductive history, with emphasis on maternal race, the number and gestational age of prior births, and the sequence of events preceding the index preterm birth. Interventions including smoking cessation, eradication of asymptomatic bacteriuria, progestational agents, and cervical cerclage can reduce the risk of recurrent preterm birth when employed appropriately. Keywordscerclage; prevention; progesterone; recurrent; preterm birth; risk estimation Efforts to reduce the incidence of preterm birth cannot yet be called successful but have produced sufficient information to justify management suggestions for clinicians, not only for strategies that do not work but also for those that do. The quality and number of clinical trials of interventions intended to reduce the incidence and/or morbidity of preterm birth has risen substantially in recent years, yielding data that can improve care for women at risk.An important advance has been the revision of the traditional model of preterm birth in which painful contractions or preterm membrane rupture were understood as the most common initial steps preceding cervical change. This concept has been challenged by observations from several clinical studies:• Drugs that arrest or inhibit uterine contractions can delay delivery but do not reliably reduce or prevent preterm birth. [1][2][3][4][5] • Assessment of contraction frequency is not a useful test to predict preterm birth, 6 and its use to detect and arrest initial or recurrent episodes of preterm labor does not affect the rate of preterm birth. [7][8][9] • Antibiotics that eradicate microorganisms associated with preterm birth also do not reliably reduce, and may sometimes increase, the incidence of preterm birth, especially in women with intact membranes. [10][11][12][13][14][15][16][17] • Progestational agents such as 17α-hydroxy-progesterone caproate reduce recurrent preterm birth in some women with a prior preterm birth, 18,19 especially those with early preterm birth 20 and short cervix, 21 but have no effect on preterm birth in multiple gestations. 22,23 NIH Public Access Author ManuscriptAm J Obstet Gynecol. Author manuscript; available in PMC 2013 May 09. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript• Cervical cerclage can reduce recurrent preterm birth in women with a prior preterm birth and short cervix 24,25 but increases the risk of preterm birth in women with multiple gestation who also have a short cervix. 24 These findings suggest the following 4 substantive changes in the "contractions change the cervi...

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Cervical length changes during preterm cervical ripening: effects of 17-α-hydroxyprogesterone caproate

Cited by 142 publications

References 23 publications

Progesterone and preterm birth prevention: translating clinical trials data into clinical practice

Progesterone and preterm birth prevention: translating clinical trials data into clinical practice

Comparative Study to Assess the Efficacy Between Intramuscular and Vaginal Micronized Progesterone to Prevent Threatened Premature Labour

Care for Women with Prior Preterm Birth

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