Dydrogesterone in threatened miscarriage: A Malaysian experience

Pandian, Ramachandhiran Udayar

doi:10.1016/j.maturitas.2009.11.016

Cited by 67 publications

(74 citation statements)

References 34 publications

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“…2010 had one study of fluoxetine (71), one of metformin (72), and one of glucose kinetics (73). In 2009, studies addressed dydrogesterone to prevent miscarriage in patients with second trimester vaginal bleeding (74), doxylamine/pyridoxine for nausea/vomiting of pregnancy (75), sumatriptan/naratriptan (76), safety of serotonin reuptake inhibitors (SSRIs)/serotonin norepinephrine reuptake inhibitors (SNRIs) (77), glyburide for gestational diabetes (78), lamotrigine for epilepsy (79), and clonidine (80). The drugs studied in 2008 were sertraline (81), enoxaparin (82), glyburide (83), aspirin in patients whose pregnancy was achieved via IVF (84), and finally midazolam and digoxin (as probe substrates studying CYP3A enzymes and P-glycoprotein) (85).…”

Section: Resultsmentioning

confidence: 99%

Obstetric Pharmacokinetic Dosing Studies are Urgently Needed

McCormack

Best

2014

Front. Pediatr.

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Use of pharmacotherapy during pregnancy is common and increasing. Physiologic changes during pregnancy may significantly alter the overall systemic drug exposure, necessitating dose changes. A search of PubMed for pharmacokinetic clinical trials showed 494 publications during pregnancy out of 35,921 total pharmacokinetic published studies (1.29%), from the late 1960s through August 31, 2013. Closer examination of pharmacokinetic studies in pregnant women published since 2008 (81 studies) revealed that about a third of the trials were for treatment of acute labor and delivery issues, a third included studies of infectious disease treatment during pregnancy, and the remaining third were for varied ante-partum indications. Approximately, two-thirds of these recent studies were primarily funded by government agencies worldwide, one-quarter were supported by private non-profit foundations or combinations of government and private funding, and slightly <10% were supported by pharmaceutical industry. As highlighted in this review, vast gaps exist in pharmacology information and evidence for appropriate dosing of medications in pregnant women. This lack of knowledge and understanding of drug disposition throughout pregnancy place both the mother and the fetus at risk for avoidable therapeutic misadventures – suboptimal efficacy or excess toxicity – with medication use in pregnancy. Increased efforts to perform and support obstetric dosing and pharmacokinetic studies are greatly needed.

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Section: Resultsmentioning

confidence: 99%

Obstetric Pharmacokinetic Dosing Studies are Urgently Needed

McCormack

Best

2014

Front. Pediatr.

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“…Each of the five randomized studies demonstrated that dydrogesterone was associated with a lower trend to miscarriage than standard care. This trend reached statistical significance in two of the studies [14,15]. In Mistò’s [12] trial, the numbers were too small to reach statistical significance.…”

Section: Resultsmentioning

confidence: 98%

“…Ehrenskjöld et al [11], used strict bed rest in addition to placebo, whereas Mistò [12], used placebo alone. Bed rest was also used in the control group in Omar et al’s [14] study and Pandian’s [15] study…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of dydrogesterone for the treatment of threatened miscarriage

Carp

2012

Gynecological Endocrinology

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The objective of this systematic review was to assess whether the orally acting progestagen, dydrogesterone lowers the incidence of miscarriage in women with threatened miscarriage. A computerized search was performed in Medline, Embase, and Ovid Medline for original reports with the product name ‘Duphaston’ or ‘dydrogesterone’, and limited to clinical human data. Twenty-one reports of dydrogesterone treatment were identified with 1380 patients. Five randomized trials were identified, including 660 women who fulfilled the criteria for metaanalysis. The number of subsequent miscarriages or continuing pregnancies per randomized woman was compared in women receiving dydrogesterone compared to standard bed rest or placebo intervention. There was a 13% (44/335) miscarriage rate after dydrogesterone administration compared to 24% in control women [odds ratio for miscarriage 0.47, (CI = 0.31–0.7), 11% absolute reduction in the miscarriage rate]. The adverse and side effects were summarized in all 21 reports, and seemed to be minimal. Although all the predictive and confounding factors could not be controlled for, the results of this systematic review show a significant reduction of 47% in the odds for miscarriage when dydrogesterone is compared to standard care indicating a real treatment effect.

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“…Threatened abortion occurs in 20% of women during early gestation and approximately half of these pregnancies will abort. 1,2 Various studies reveals that, progesterone can decrease pregnancy loss in women with threatened abortion. [3][4][5][6] In our study, depending upon the type of smear 'Maturation Index' (MI) i.e.…”

Section: Introductionmentioning

confidence: 99%

Role of cytohormonal study in normal pregnancy and in threatened abortion

Patil

2018

Int J Reprod Contracept Obstet Gynecol

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Background: It is certain from clinical experience of many that one or more hemorrhages in early pregnancy can still end up in good fetal outcome. So, our study deals with comparison of cytohormonal study in pregnancy and threatened abortion. The study was conducted with the aim of utilizing colpocytogram as a tool in assessing and treating cases of threatened abortion and comparing them with normal pregnant women. Methods: Patients attending antenatal care unit on outdoor basis and labelled as normal pregnancy cases were considered as control group. The patients of threatened abortion were studied when they were admitted in Gynecology department for indoor treatment. Patients were studied taking into consideration their age, parity, number of abortions, complaints (P/V bleeding, pain in abdomen), gestational age, per abdomen and per vaginal findings and also USG findings and vaginal smear pattern. Results: Maximum number of patients was present in the age group of 21-25 years in both the groups. While only 13.33% had normal smear pattern in threatened abortion group. 86.67% patients in threatened abortion group showed abnormal smear pattern. There is statistically significant difference was found (p<0.05). There is statistically significant was found (P<0.01) and indicates good effects of the drug on the vaginal epithelium. Conclusions: The cytohormonal study acts as a simple, reliable, good, noninvasive method for evaluation of hormonal pattern in normal pregnancy and threatened abortion.

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Dydrogesterone in threatened miscarriage: A Malaysian experience

Cited by 67 publications

References 34 publications

Obstetric Pharmacokinetic Dosing Studies are Urgently Needed

Obstetric Pharmacokinetic Dosing Studies are Urgently Needed

A systematic review of dydrogesterone for the treatment of threatened miscarriage

Role of cytohormonal study in normal pregnancy and in threatened abortion

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