Prevention of Preterm Birth Based on Short Cervix: Progesterone

Fonseca, Eduardo Borges da; Damião, Rievani; Nicholaides, Kypros

doi:10.1053/j.semperi.2009.06.006

Cited by 15 publications

(12 citation statements)

References 39 publications

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“…This approach has not been successful, as such interventions are usually performed too late in the process to succeed. A second problem with the current management of preterm labor is that only women who have clear risk factors (abnormally short cervixes) or a history of PTBs are targeted for interventions designed to prevent PTB (26–30). The vast majority of PTBs occur in women who are considered low-risk because they are either on their first pregnancies or have only had term births previously (31–37).…”

mentioning

confidence: 99%

Oxidative Stress Damage as a Detrimental Factor in Preterm Birth Pathology

2014

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Normal term and spontaneous preterm births (PTB) are documented to be associated with oxidative stress (OS), and imbalances in the redox system (balance between pro- and antioxidant) have been reported in the maternal–fetal intrauterine compartments. The exact mechanism of labor initiation either at term or preterm by OS is still unclear, and this lack of understanding can partially be blamed for failure of antioxidant supplementation trials in PTB prevention. Based on recent findings from our laboratory, we postulate heterogeneity in host OS response. The physiologic (at term) and pathophysiologic (preterm) pathways of labor are not mediated by OS alone but by OS-induced damage to intrauterine tissues, especially fetal membranes of the placenta. OS damage affects all major cellular elements in the fetal cells, and this damage promotes fetal cell senescence (aging). The aging of the fetal cells is predominated by p38 mitogen activated kinase (p38MAPK) pathways. Senescing cells generate biomolecular signals that are uterotonic, triggering labor process. The aging of fetal cells is normal at term. However, aging is premature in PTB, especially in those PTBs complicated by preterm premature rupture of the membranes, where elements of redox imbalances and OS damage are more dominant. We postulate that fetal cell senescence signals generated by OS damage are likely triggers for labor. This review highlights the mechanisms involved in senescence development at term and preterm by OS damage and provides insight into novel fetal signals of labor initiation pathways.

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confidence: 99%

Oxidative Stress Damage as a Detrimental Factor in Preterm Birth Pathology

2014

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“…The exact systems by which a blockade of progesterone activity may prompt cervical changes are intricate and inadequately interpreted. A decrease in progesterone activity most likely causes cervical changes by the action of inflammatory mediators [16].…”

Section: Discussionmentioning

confidence: 99%

Role of 17-Hydroxyprogesterone Caproate as an Adjuvant Therapy in Women With Cervical Cerclage for Prevention of Preterm Delivery: A Retrospective Matched Controlled Study

Fatema

Elawdy

Rahman

et al. 2017

J Clin Gynecol Obstet

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“…This study showed that preterm delivery decreased significantly with the administration of progestin. 25,26 Dodd et al performed a meta-analysis from 11 randomized clinical trials (RCT) about the use of intramuscular progestin 17 alpha-hydroxyprogesterone caproate (17 OHP-C) and four RCTs about the intravaginal use of natural microionized progesterone. This meta-analysis demonstrates that prevention of preterm delivery using both natural and synthetic progestin may decrease preterm delivery rate and low birth weight for babies in impending preterm delivery cases.…”

Section: Introductionmentioning

confidence: 99%

“…27 Other study suggests that women with single pregnancy, no history of preterm delivery and cervical length of ≤2 cm, who receive intravaginal progestin (gel) 90 mg or 200 mg suppositories, are related to the reduction of preterm delivery and perinatal morbidity and mortality. 25,[28][29][30][31][32] Natural progesterone administration has no side effects for the fetus growth and development, nor adding any risk for congenital anomaly. Northen et al stated that after 4 years of observation in 278 children whose mothers received long-term natural progesterone therapy during pregnancy, none had side-effects based on the physical examination, motoric and personal-social ability.…”

Section: Introductionmentioning

confidence: 99%

The Role of Natural Progesterone Administration on the Levels of Progesterone-induced Blocking Factor, Interleukin-10 and the Prolongation of Gestational Length in Impending Preterm Delivery

Thipasary¹,

Effendi²,

Anwar³

2015

Journal of South Asian Federation of Obstetrics and Gynaecology

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Progesterone plays an important role in maintaining pregnancy. The success of pregnancy depends on the balance of immune response between the mother and the fetus. Progesterone regulates the immunological response through progesteroneinduced blocking factor (PIBF) which is synthesized by lymphocytes. Progesterone-induced blocking factor inhibits the production of arachidonic acid, reduced NK cell activity, and modulates the cytokine balance by increasing interleukin-10 (IL-10) level that is produced by Th2. This study aims to determine the roles of natural progesterone administration on PIBF and IL-10 levels and the increase in gestational length. This is an experimental research with pre-and post-test design. Subjects were pregnant women who met the criteria (n = 22). The treatment was done for 7 days. Progesteroneinduced blocking factor and IL-10 levels were measured before and after the administration of natural progesterone and the length of gestation were noted. The study was conducted at Dr Hasan Sadikin Hospital within July to December 2013.Results showed that after the administration of natural progesterone, there were increases on PIBF (p = 0.039) and IL-10 levels (p = 0.031). A positive correlation was noted between PIBF and IL-10 levels (r = 0.549; Spearman rank correlation test). There was also positive correlation between PIBF serum level (moderate strength correlation) and the length of gestation (r = 0.428; Point biserial correlation test). Progesterone-induced blocking factor serum level had more influence on the prolongation of the pregnancy compared to IL-10 level (OR: 1.016, 95% CI: 1.001 to 1.03; p = 0.033).Increased levels of PIBF and IL-10 after the administration of natural progesterone on the impending preterm delivery may prolong the gestation. Progesterone-induced blocking factor serum level have more dominant role in prolongation of gestation compared to IL-10.

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Prevention of Preterm Birth Based on Short Cervix: Progesterone

Cited by 15 publications

References 39 publications

Oxidative Stress Damage as a Detrimental Factor in Preterm Birth Pathology

Oxidative Stress Damage as a Detrimental Factor in Preterm Birth Pathology

Role of 17-Hydroxyprogesterone Caproate as an Adjuvant Therapy in Women With Cervical Cerclage for Prevention of Preterm Delivery: A Retrospective Matched Controlled Study

The Role of Natural Progesterone Administration on the Levels of Progesterone-induced Blocking Factor, Interleukin-10 and the Prolongation of Gestational Length in Impending Preterm Delivery

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