Combined therapy with vaginal progesterone, Arabin cervical pessary and cervical cerclage to prevent preterm delivery in high-risk women

Shor, Shimrit; Zimerman, Ariel; Maymon, Ron; Kovo, Michal; Wolf, Maya Frank; Wiener, Ifat; Bar, Jacob; Melcer, Yaakov

doi:10.1080/14767058.2019.1659771

Cited by 17 publications

(12 citation statements)

References 27 publications

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“…The SMFM recommends continuation of 17-OHPC in women who receive an ultrasound-indicated cerclage [ 66 ]. Most recently, Shor et al said that a combined rescue therapy including vaginal progesterone, cervical cerclage, and Arabin cervical pessary emerges as a promising management strategy in pregnant women who have a short cervical length and a high background risk for preterm delivery [ 67 ]. The possible advantages of a combined approach were also considered for twin pregnancies.…”

Section: Progesterone and Ptb: Where We Are Nowmentioning

confidence: 99%

Prevention of Preterm Birth with Progesterone

Renzo

Tosto

Цибизова

et al. 2021

JCM

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Gestational age at birth is a critical factor for perinatal and adulthood outcomes, and even for transgenerational conditions’ effects. Preterm birth (PTB) (prematurity) is still the main determinant for infant mortality and morbidity leading cause of infant morbidity and mortality. Unfortunately, preterm birth (PTB) is a relevant public health issue worldwide and the global PTB rate is around 11%. The premature activation of labor is underlined by complex mechanisms, with a multifactorial origin influenced by numerous known and probably unknown triggers. The possible mechanisms involved in a too early labor activation have been partially explained, and involve chemokines, receptors, and imbalanced inflammatory paths. Strategies for the early detection and prevention of this obstetric condition were proposed in clinical settings with interesting results. Progesterone has been demonstrated to have a key role in PTB prevention, showing several positive effects, such as lower prostaglandin synthesis, the inhibition of cervical stromal degradation, modulating the inflammatory response, reducing gap junction formation, and decreasing myometrial activation. The available scientific knowledge, data and recommendations address multiple current areas of debate regarding the use of progesterone in multifetal gestation, including different formulations, doses and routes of administration and its safety profile in pregnancy.

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Section: Progesterone and Ptb: Where We Are Nowmentioning

confidence: 99%

Prevention of Preterm Birth with Progesterone

Renzo

Tosto

Цибизова

et al. 2021

JCM

View full text Add to dashboard Cite

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“…The use of this 15-mm threshold is directly supported by the earlier Owen et al 28 study. [29][30][31]…”

Section: Singleton Pregnancy Prior Spontaneous Preterm Birthmentioning

confidence: 99%

“…It is important to note that for women who receive an ultrasound-indicated cerclage, there are data favoring co-treatment with vaginal progesterone, so this can also be considered in the setting of shared decision making. [29][30][31]…”

Section: Multiple Gestationmentioning

confidence: 99%

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Reassessing Preterm Birth Prevention After the Withdrawal of 17-α Hydroxyprogesterone Caproate

Heyborne

2023

Obstetrics &Amp; Gynecology

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The U.S. Food and Drug Administration has recently withdrawn approval for 17-α hydroxyprogesterone caproate for prevention of recurrent preterm birth, and recent studies have called into question benefits of the pessary in the setting of a short cervix. Obstetric health care professionals are once again left with limited remaining options for preterm birth prevention. This narrative review summarizes the best current evidence on the use of vaginal progesterone, low-dose aspirin, and cerclage for the prevention of preterm birth; attempts to distill possible lessons learned from studies of progesterone and pessary, as well as their implementation into practice; and highlights areas where inroads into preterm birth prevention may be possible outside of the progesterone–aspirin–cerclage paradigm.

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“…However, we must remind the reader that the rates of obstetric complications are different in Europe than in developing countries. From Iran, Azargoon et al reported PTD in 68% of placebo cases; 8 from India, Rai et al 9 reported PTD in 59.5% of their cases and from Israel, Shor et al found a 44.4% rate of PTD 10. …”

mentioning

confidence: 99%

Oral micronized progesterone is effective for preventing preterm delivery

Ashoush

2019

Acta Obstet Gynecol Scand

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Combined therapy with vaginal progesterone, Arabin cervical pessary and cervical cerclage to prevent preterm delivery in high-risk women

Cited by 17 publications

References 27 publications

Prevention of Preterm Birth with Progesterone

Prevention of Preterm Birth with Progesterone

Reassessing Preterm Birth Prevention After the Withdrawal of 17-α Hydroxyprogesterone Caproate

Oral micronized progesterone is effective for preventing preterm delivery

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