Review on role of progestogen (dydrogesterone) in the prevention of gestational hypertension

Razi, Zainul Rashid Mohamad; Schindler, A. E.

doi:10.1515/hmbci-2015-0070

Cited by 8 publications

(5 citation statements)

References 23 publications

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“…Dydrogesterone is a synthetic progestin with enhanced oral bioavailability, known for being highly selective for the progesterone receptor ( Kupferminc et al ., 1990 ; Domitrz et al ., 1999 ). It is effective in treating reproductive disorders such as threatened abortion and recurrent pregnancy loss, and has also been investigated in the prevention of gestational hypertension and preterm birth ( Carp, 2012 ; 2015 ; Hudic et al ., 2016 ; Mohamad Razi et al ., 2016 ). Dydrogesterone has also been described to provide similar reproductive results as vaginal progesterone ( van der Linden et al ., 2015 ; Barbosa et al ., 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Oral dydrogesterone vs. vaginal progesterone capsules for luteal-phase support in women undergoing embryo transfer: a systematic review and meta-analysis

Mwp¹,

Npb²,

Acp³

et al. 2018

JBRA Assisted Reproduction

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ObjectiveTo identify, appraise, and summarize the evidence from randomized controlled trials (RCTs) comparing oral dydrogesterone to vaginal progesterone capsules for luteal-phase support (LPS) in women offered fresh or frozen embryo transfers following in vitro fertilization.MethodsTwo independent authors screened the literature for papers based on titles and abstracts, then selected the studies, extracted data, and assessed the risk of bias. Dydrogesterone and progesterone were compared based on risk ratios (RR) and the precision of the estimates was assessed through the 95% confidence interval (CI).ResultsAn electronic search performed on June 7, 2017 retrieved 376 records, nine of which were papers deemed eligible and included in this systematic review and quantitative analysis. Good quality evidence indicates that oral dydrogesterone provided at least similar results than vaginal progesterone capsules on live birth/ongoing pregnancy (RR=1.08, 95%CI=0.92-1.26, I2=29%, 8 RCTs, 3,386 women) and clinical pregnancy rates (RR 1.10, 95% CI 0.95 to 1.27; I2=43%; 9 RCTs; 4,061 women). Additionally, moderate quality evidence suggests there is no relevant difference on miscarriage rates (RR=0.92, 95%CI=0.68-1.26, I2=6%, 8 RCTs, 988 clinical pregnancies; the quality of the evidence was downgraded because of imprecision).ConclusionsGood quality evidence from RCTs suggest that oral dydrogesterone provides at least similar reproductive outcomes than vaginal progesterone capsules when used for LPS in women undergoing embryo transfers. Dydrogesterone is a reasonable option and the choice of either of the medications should be based on cost and side effects.

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Section: Introductionmentioning

confidence: 99%

Oral dydrogesterone vs. vaginal progesterone capsules for luteal-phase support in women undergoing embryo transfer: a systematic review and meta-analysis

Mwp¹,

Npb²,

Acp³

et al. 2018

JBRA Assisted Reproduction

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“…Gestational hypertension is a complication that specifically occurs in late pregnancy, and includes gestational hypertension, preeclampsia, eclampsia and chronic hypertension ( 1 , 2 ). A clinical investigation suggested that hypertensive disorder is a complication during pregnancy, is a common pregnancy-associated disease and is becoming increasingly present worldwide ( 3 ). However, the etiology of gestational hypertension is yet to be clearly investigated.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, there are a large number of factors that may induce gestational hypertension, and have been found to serve a role in the etiology of these hypertensive disorders, including work stress, depression and anxiety ( 12 , 13 ). Reports also have indicated that angiotensin II type 1 receptor (Ang-IITR), vasodilation converting enzyme (VCE) and α-1A adrenergic receptor (α-ADR) serve crucial roles in the process of gestational hypertension and may be potential targets for the treatment of patients with gestational hypertension in clinical ( 3 , 12 , 13 ). Therefore, a large number of drugs targeting Ang-IITR were introduced and their therapeutic effects for the treatment of gestational hypertension were evaluated.…”

Section: Introductionmentioning

confidence: 99%

Candesartan targeting of angiotensin II type 1 receptor demonstrates benefits for hypertension in pregnancy via the NF‑κB signaling pathway

Zhao

Wang

2018

Mol Med Report

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Hypertensive disorders may be a complication of pregnancy and are characterized by the high blood pressure. Evidence suggests that alterations in the renin-angiotensin-aldosterone system and the sympathetic nervous system are associated with gestational hypertension. Angiotensin II type 1 receptor (Ang-IITR) is a potential target in the progression of gestational hypertension. Candesartan is selective Ang-IITR antagonist that may act against vasoconstriction and reduces peripheral vascular resistance. The aim of the present study was to evaluate the efficacy of Candesartan and the underlying molecular mechanism of the nuclear factor-κB (NF-κB) signaling pathway in the progression of gestational hypertension in a mouse model. Expression and activity of Ang-IITR was evaluated in a mouse model of gestational hypertension prior to and post-treatment of Candesartan both in vitro and in vivo. It was determined whether Candesartan treatment reduces higher blood pressure activated the renal renin-angiotensin system and a prognostic marker, soluble endoglin, and its associated gene in mice with gestational hypertension. Angiotensin-converting enzyme plasma levels and activity were also evaluated in the present study. Cytoplasmic and nuclear immunostaining of NF-κB and associated proteins transforming growth factor β (TGF-β) and endoglin was enhanced in vascular endothelial cells and mice with gestational hypertension. Soluble fms-like tyrosine kinase 1 (sFlt-1), insulin resistance homeostasis model assessment score and associated cardiovascular risk factors also were measured. Results demonstrated that angiotensin and Ang-IITR expression levels were upregulated in mice with gestational hypertension and were downregulated by Candesartan treatment. Renal renin-angiotensin and soluble endoglin were also improved in mice in the Candesartan-treated group. In addition, Candesartan treatment enhanced NF-κB activity, as well as TGF-β and vascular endothelial growth factor expression which led to improved levels of sFlt-1, insulin resistance homeostasis and associated cardiovascular risk factors. Gestational hypertension was markedly improved by treatment of Candesartan compared with the control. In conclusion, the findings of the present study suggested that the NF-κB signaling pathway may be involved in with Candesartan-mediated Ang-IITR for the treatment of gestational hypertension.

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“…In several species, it is recognized that hormonal status can influence systemic blood pressure. In women, Mohamad Razi and Schindler () showed that progesterone decreases systemic blood pressure, thus preventing gestational hypertension. Additionally, Zhao et al.…”

Section: Introductionmentioning

confidence: 99%

Uterine haemodynamic, vascularization and blood pressure changes along the oestrous cycle in bitches

Nogueira

Almeida

Angrimani

et al. 2016

Reprod Domestic Animals

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ContentsCharacterization of the bitch's reproductive physiology is of utmost importance for the development of new reproductive techniques and the diagnosis of reproductive diseases. In this respect, uterine B-mode ultrasonography has been employed in several studies; however, the focus on haemodynamic changes along the oestrous cycle is yet to be described. Thus, the aim of this study was to characterize haemodynamic changes (uterine vascularization, systemic arterial blood pressure and heart rate) throughout the oestrous cycle in bitches. For this purpose, ten Golden Retriever bitches were evaluated during an entire oestrous cycle, twice during each stage of the cycle. Uterine artery blood flow, velocity wave forms, haemodynamic parameters and vascularization were analysed by Doppler ultrasonography. Furthermore, uterine diameter, arterial blood pressure and heart rate were measured. Uterine artery pulsatility index at early prooestrus was significantly lower in comparison with early oestrus, mid-and late anoestrus. Uterine artery resistance index was higher at early oestrus when compared to late oestrus and uterine diameter was significantly higher during late prooestrus. Furthermore, mean arterial blood pressure was lower and heart rate was higher during late prooestrus in comparison with the other oestrous cycle stages.In conclusion, haemodynamic changes in the uterine artery, uterine diameter, systemic blood pressure and heart rate occur during the canine oestrous cycle. Specifically, there is an increase in uterine artery perfusion, uterine diameter and mean arterial blood pressure during prooestrus, while uterine blood flow diminishes during oestrus and anoestrus.

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Review on role of progestogen (dydrogesterone) in the prevention of gestational hypertension

Abstract: Supplementation of the progestogen, dydrogesterone, in the first trimester to primigravidae has shown great potential in reducing or preventing the incidence of gestational hypertension.

Cited by 8 publications

References 23 publications

Oral dydrogesterone vs. vaginal progesterone capsules for luteal-phase support in women undergoing embryo transfer: a systematic review and meta-analysis

Oral dydrogesterone vs. vaginal progesterone capsules for luteal-phase support in women undergoing embryo transfer: a systematic review and meta-analysis

Candesartan targeting of angiotensin II type 1 receptor demonstrates benefits for hypertension in pregnancy via the NF‑κB signaling pathway

Uterine haemodynamic, vascularization and blood pressure changes along the oestrous cycle in bitches

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