Prevention of recurrence of pre-term birth by progesterone
Summary :
Table of Contents
- Abstract
- Physiopathological justification of the use of progesterone to prevent preterm birth
- Studies on the use of progesterone as tocolytique
- Studies on the use of progesterone in prevention of recurrent preterm delivery
- The older studies
- Recent studies
- Risks associated with the use of progesterone during pregnancy
- Strategies for preventing recurrent preterm delivery
- Conclusion
- References
Abstract
For years, the prescription of progesterone in the event of a threat of premature birth was normal, despite the absence of any demonstration of a fetal or neonatal benefit in this situation. The description of an increased risk of cholestasis of pregnancy during this treatment was terminated this requirement.
Recently, several randomized double-blind study showed a benefit of progesterone in preventing the risk of recurrence of prematurity. This review includes the physiopathological justification of the use of progesterone, discusses the biases and limitations of earlier studies and describes the two recent randomized trials which could use progesterone "fashionable."
The data from these trials do not seem convincing that the preventive use of 17 alpha-hydroxyprogesterone injection started early during pregnancy in women with a history of prematurity. This requirement could be integrated in a more comprehensive preventive strategy in which the cervical cerclage and preventive treatment of bacterial vaginosis may also have their place.
Recently, several randomized double-blind study showed a benefit of progesterone in preventing the risk of recurrence of prematurity. This review includes the physiopathological justification of the use of progesterone, discusses the biases and limitations of earlier studies and describes the two recent randomized trials which could use progesterone "fashionable."
The data from these trials do not seem convincing that the preventive use of 17 alpha-hydroxyprogesterone injection started early during pregnancy in women with a history of prematurity. This requirement could be integrated in a more comprehensive preventive strategy in which the cervical cerclage and preventive treatment of bacterial vaginosis may also have their place.
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