Document Detail


Pharmacological use of progesterone and 17-alpha-hydroxyprogesterone caproate in the prevention of preterm delivery.
MedLine Citation:
PMID:  19749671     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Preterm delivery (PTD) is defined by the World Health Organization as birth before 37 completed weeks of gestation. In Western countries, PTD accounts for over 75% of all perinatal morbidity and mortality. The social importance of PTD derives from the consideration that it causes near three quarter of neonatal deaths not caused by malformations. Progesterone is a steroid hormone which plays a crucial role in each step of human pregnancy. Early in pregnancy progesterone is produced by the corpus luteum and it is fundamental for pregnancy maintenance until placenta takes over this function at 7-9 weeks of gestation. Late in pregnancy, the role of progesterone is less clear: certainly, it may be importance in maintaining uterine quiescence in the latter half of pregnancy by limiting the production of stimulatory prostaglandins and inhibiting the expression of contraction-associated protein genes (ion channels, oxytocin and prostaglandin receptors, and gap junctions) within the myometrium. In this review, the authors included those controlled clinical studies that have used either 17 hydroxy progesterone caproate (17P), or progesterone (P) or its synthetic derivatives (progestins) in order to avoid or reduce the incidence of preterm delivery, in populations of women at increased risk of preterm birth. The authors conclude that: 1) the treatment with 17P reduces the incidence of PTD in pluriparous women with a previous history of PTD or with recurrent abortion, as well as in nulliparous women with an actual risk; 2) the treatment with P reduces PTD in nulliparous women, namely in the presence of a silent cervical shortening; 3) 17P has no efficacy in multiple pregnancy and it is proven not to have adverse effects on the infants.
Authors:
F Facchinetti; V Vaccaro
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Minerva ginecologica     Volume:  61     ISSN:  0026-4784     ISO Abbreviation:  Minerva Ginecol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-14     Completed Date:  2010-02-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400731     Medline TA:  Minerva Ginecol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  401-9     Citation Subset:  IM    
Affiliation:
Unit of Gynecology and Obstetrics, Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy. facchi@unimore.it
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MeSH Terms
Descriptor/Qualifier:
Abortion, Habitual / drug therapy
Anti-Inflammatory Agents / administration & dosage,  therapeutic use
Female
Humans
Hydrocortisone / antagonists & inhibitors
Hydroxyprogesterones / administration & dosage,  therapeutic use*
Infant, Newborn
Obstetric Labor, Premature / prevention & control*
Pregnancy
Pregnancy Maintenance / drug effects,  physiology
Pregnancy Outcome
Progesterone / administration & dosage,  physiology,  therapeutic use*
Progesterone Congeners / administration & dosage,  therapeutic use*
Prostaglandins / physiology
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Hydroxyprogesterones; 0/Progesterone Congeners; 0/Prostaglandins; 50-23-7/Hydrocortisone; 57-83-0/Progesterone; 630-56-8/17-alpha-hydroxy-progesterone caproate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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