Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy

Dodd, Jodie M; Grivell, Rosalie M; O’Brien, Cecelia M.; Dowswell, Therese; Deussen, Andrea R

doi:10.1002/14651858.cd012024.pub2

Cited by 40 publications

(19 citation statements)

References 121 publications

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“…Administration of progesterone agents could prevent SPTD, but in multiple pregnancies, it does not appear to be associated with a reduction in the risk of preterm birth . Thus, it is not known whether 17OHP‐C is effective for preventing preterm labor (PTL).…”

Section: Discussionmentioning

confidence: 99%

“…Administration of progesterone agents could prevent SPTD, 10 but in multiple pregnancies, it does not appear to be associated with a reduction in the risk of preterm birth. 24 Thus, it is not known whether 17OHP-C is effective for preventing preterm labor (PTL). However, 17OHP-C, which might be effective in limited PTL cases with mild sterile intra-amniotic inflammation, 11 was administered prophylactically from 16 weeks.…”

Section: Discussionmentioning

confidence: 99%

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Multiple management strategies to prolong gestational period after radical trachelectomy

Ito

Yoneda

Shiozaki

et al. 2019

Clinical Case Reports

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multiple management strategies to prolong gestational period after radical trachelectomy

Ito

Yoneda

Shiozaki

et al. 2019

Clinical Case Reports

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show abstract

“…Остается спорным вопрос и об эффективности и безопасности применения прогестагенов и их аналогов у женщин с многоплодной беременностью, хотя в последнее время появляется все больше данных о возможности снижения частоты преждевременных родов и улучшения перинатальных исходов многоплодной беременности при использовании препаратов прогестерона [25].…”

Section: производные прогестеронаunclassified

“…При этом отсутствовали какие-либо явные групповые различия в неонатальных исходах, кроме искусственной вентиляции легких, потребность в которой была меньше у детей, чьи матери получили вагинальный прогестерон (Ор 0,61; 95 % ДИ 0,48-0,77; младенцы -3134, исследования -5). было отмечено, что у женщин с многоплодной беременностью использование прогестерона (как внутримышечного, так и вагинального), вероятно, не связано со снижением риска преждевременных родов или улучшением исходов для новорожденных [33].…”

Section: производные прогестеронаunclassified

Prevention and therapy of threatened preterm birth in multiple pregnancy

et al. 2019

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Preterm birth in multiple pregnancy is an important medical, economic and social problem. Currently, more than half of twins are born prematurely, which puts them at high risk of developing neonatal diseases causing lifelong disability and social maladjustment. In this regard, reducing the frequency of preterm multiple births is an important task of modern obstetrics. Improving perinatal outcomes of multiple pregnancies can only be achieved using the most effective measures that have a good evidence base. At the same time, numerous studies on the effectiveness of therapeutic interventions aimed at prolonging multiple pregnancies have reported contradictory results. This review included most of the randomized controlled trials of methods for the prevention and treatment of threatening preterm birth in multiple pregnancies, as available in PubMed, Google Academy, Elibrary, and the Cochrane Central Register of Controlled Trials. Thus far, studies on the use of bed rest, prophylactic tocolysis, most of the progestins, and cervical cerclage in multiple pregnancy have shown no efficacy in reducing the risk of premature birth. However, encouraging data were obtained on improving neonatal outcomes of multiple pregnancies using vaginal progesterone and an obstetric pessary, but these results require additional confirmation in larger multicenter randomized studies. Further clinical trials are needed to develop algorithms for timely diagnosis and adequate treatment of threatened preterm birth in case of multiple pregnancy, including the use of the most rational preventive and therapeutic methods that have a high evidence level.

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“…In twins, CL has a low sensitivity; hence, women at risk are not being identified [6,7]. Moreover, at present, there is no useful intervention to prevent sPTB in twins, but this could be due to the misidentification of women at risk [8].…”

Section: Introductionmentioning

confidence: 99%

The Predictive Value of the Cervical Consistency Index to Predict Spontaneous Preterm Birth in Asymptomatic Twin Pregnancies at the Second-Trimester Ultrasound Scan: A Prospective Cohort Study

Merwe

Couck

Russo

et al. 2020

JCM

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Novel transvaginal ultrasound (TVU) markers have been proposed to improve spontaneous preterm birth (sPTB) prediction. Preliminary results of the cervical consistency index (CCI), uterocervical angle (UCA), and cervical texture (CTx) have been promising in singletons. However, in twin pregnancies, the results have been inconsistent. In this prospective cohort study of asymptomatic twin pregnancies assessed between 18+0–22+0 weeks, we evaluated TVU derived cervical length (CL), CCI, UCA, and the CTx to predict sPTB < 34+0 weeks. All iatrogenic PTB were excluded. In the final cohort of 63 pregnancies, the sPTB rate < 34+0 was 16.3%. The CCI, UCA, and CTx, including the CL was significantly different in the sPTB < 34+0 weeks group. The best area under the receiver operating characteristic curve (AUC) for sPTB < 34+0 weeks was achieved by the CCI 0.82 (95%CI, 0.72–0.93), followed by the UCA with AUC 0.72 (95%CI, 0.57–0.87). A logistic regression model incorporating parity, chorionicity, CCI, and UCA resulted in an AUC of 0.91 with a sensitivity of 55.3% and specificity of 88.1% for predicting sPTB < 34+0. The CCI performed better than other TVU markers to predict sPTB < 34+0 in twin gestations, and the best diagnostic accuracy was achieved by a combination of parity, chorionicity, CCI, and UCA.

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Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy

Abstract: Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy.

Cited by 40 publications

References 121 publications

Multiple management strategies to prolong gestational period after radical trachelectomy

Multiple management strategies to prolong gestational period after radical trachelectomy

Prevention and therapy of threatened preterm birth in multiple pregnancy

The Predictive Value of the Cervical Consistency Index to Predict Spontaneous Preterm Birth in Asymptomatic Twin Pregnancies at the Second-Trimester Ultrasound Scan: A Prospective Cohort Study

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