Progesterone inhibits in vitro fetal membrane weakening

Kumar, Deepak; Springel, Edward; Moore, Robert M.; Mercer, Brian M.; Philipson, Elliot H.; Mansour, Joseph M.; Mesiano, Sam; Schatz, Fredrick; Lockwood, Charles J.; Moore, John J.

doi:10.1016/j.ajog.2015.06.014

Cited by 53 publications

(37 citation statements)

References 61 publications

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“…15 In two studies of women presenting with threatened preterm labor, high probability of delivery in 7 days was noticed if cervical length was less than 15 mm. 16 Women with history of preterm labor have higher rates of recurrence as compared to those who don't have any prior history i.e. 22% vs. 9%.…”

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Effectiveness of Vaginal versus Intramuscular Progesterone for the Prevention of Preterm Delivery

Wajid¹,

Zafar²,

Waheed³

2016

Annals KEMU

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Objective: The objective was to compare the effectiveness of vaginal versus intramuscular progesterone to prevent preterm delivery in patients with history of preterm labor in previous pregnancy. Patients and Methods: It was a Randomized Control Trial carried out in the Gynecology Unit in a Public sector Hospital, Lahore from March to December 2015. A total of 800 patients were enrolled through Antenatal OPD and were randomly divided into two groups by draw method. In Group-A, patients were administered 200mg of vaginal progesterone pessary once daily and in Group-B 250 mg of intramuscular progesterone was injected weekly. Treatment was continued until 37 completed weeks of gestation. The patients were followed up through their contact numbers and on routine follow up. This practice was abandoned if premature rupture of membranes occurred and the fetus was delivered before 37 weeks. All the parameters were recorded by the researcher on proforma. The data was analyzed using Statistical Package for the Social Sciences (SPSS) version 16.0. Chi Square test was applied to draw the comparison. Results: The mean age of patients was 26.16 ± 5.36 years (18 -35 years). The 296 patients were Para 1, 290 were Para 2, 142 were Para 3, 51 were Para 4 and 21 females were Para 5. In all females, the mean gestational age at time of presentation was 22.00 ± 1.47 weeks, whereas, at time of delivery, mean gestational age was 36.05 ± 2.38 weeks. In vaginal progesterone group, the mean gestational age at time of delivery was 36.67 ± 1.92 weeks while in IM group, mean gestational age at time of delivery was 35.43 ± 2.62 weeks. The difference between both groups was statistically significant (P < 0.05). Effectiveness (delivery ≥ 37 weeks) was achieved in 379 (47%) cases, out of which 228 (57%) cases belonged to vaginal progesterone group and 151 (37.8%) cases belonged to IM progesterone group (P < 0.05). Post stratification with age and parity also showed that vaginal progesterone is more efficacious than IM progesterone (P < 0.05). Conclusion: We concluded that vaginal progesterone is more effective than intramuscular progesterone for the prevention of preterm labor in patients with history of preterm labor in previous pregnancy.

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“…22% vs. 9%. [15][16][17] Progesterone is generated by the corpus luteum in early pregnancy. Progesterone is crucial for pregnancy continuation until the placenta becomes responsible for this job.…”

mentioning

confidence: 99%

Effectiveness of Vaginal versus Intramuscular Progesterone for the Prevention of Preterm Delivery

Wajid¹,

Zafar²,

Waheed³

2016

Annals KEMU

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“…26 We have demonstrated in both clinical human FM specimens, and from our in-vitro human FM weakening model, that FM remodeling associated with collagen degradation and cellular apoptosis plays an important role in FM weakening. 4,12,13,27-33 Biochemically pre-weakened FM more readily fail as a result of the mechanical forces of uterine contractions at the onset of labor. This is supported by the known interplay between mechanical deformation and collagen degradation in other collagenous soft tissues both of which perhaps works synergistically to induce tissue failure.…”

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confidence: 99%

In-vivo stretch of term human fetal membranes

et al. 2016

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Introduction Fetal membranes (FM) usually fail prior to delivery during term labor, but occasionally fail at preterm gestation, precipitating preterm birth. To understand the FM biomechanical properties underlying these events, study of the baseline in-vivo stretch experienced by the FM is required. This study's objective was to utilize high resolution MRI imaging to determine in-vivo FM stretch. Methods Eight pregnant women (38.4±0.4wks) underwent abdominal-pelvic MRI prior to (2.88±0.83d) caesarean delivery. Software was utilized to determine the total FM in-vivo surface area (SA) and that of its components: placental disc and reflected FM. At delivery, the SA of the disc and FM in the relaxed state were measured. In-vivo (stretched) to delivered SA ratios were calculated. FM fragments were then biaxially stretched to determine the force required to re-stretch the FM back to in-vivo SA. Results Total FM SA, in-vivo vs delivered, was 2135.51±108.47 cm2 vs 842.59±35.86 cm2; reflected FM was 1778.42±107.39 cm2 vs 545.41±22.90 cm2, and disc was 357.10±28.08 cm2 vs 297.18±22.14 cm2. The ratio (in-vivo to in-vitro SA) of reflected FM was 3.26±0.11 and disc was 1.22±0.10. Reflected FM re-stretched to in-vivo SA generated a tension of 72.26N/m, corresponding to approximate pressure of 15.4mmHg. FM rupture occurred at 295.08 ± 31.73N/m corresponding to approximate pressure of 34mmHg. Physiological SA was 70% of that at rupture. Discussion FM are significantly distended in-vivo. FM collagen fibers were rapidly recruited once loaded and functioned near the failure state during in-vitro testing, suggesting that, in-vivo, minimal additional (beyond physiological) stretch may facilitate rapid, catastrophic failure.

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“…Membranes also regulate several endocrine signals (Li & Challis 2005, Menon et al 2008, Kumar et al 2015, Meng et al 2016. Although fetal membranes and the placenta are both fetal in origin, are attached to one another and develop together with the fetus, placenta and fetal membranes have distinct cellularity and physiology.…”

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confidence: 99%

Positive and negative effects of cellular senescence during female reproductive aging and pregnancy

Velarde

Menon

2016

Journal of Endocrinology

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Cellular senescence is a phenomenon occurring when cells are no longer able to divide even after treatment with growth stimuli. Because senescent cells are typically associated with aging and age-related diseases, cellular senescence is hypothesized to contribute to the age-related decline in reproductive function. However, some data suggest that senescent cells may also be important for normal physiological functions during pregnancy. Herein, we review the positive and negative effects of cellular senescence on female reproductive aging and pregnancy. We discuss how senescent cells accelerate female reproductive aging by promoting the decline in the number of ovarian follicles and increasing complications during pregnancy. We also describe how cellular senescence plays an important role in placental and fetal development as a beneficial process, ensuring proper homeostasis during pregnancy.

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Progesterone inhibits in vitro fetal membrane weakening

Cited by 53 publications

References 61 publications

Effectiveness of Vaginal versus Intramuscular Progesterone for the Prevention of Preterm Delivery

Effectiveness of Vaginal versus Intramuscular Progesterone for the Prevention of Preterm Delivery

In-vivo stretch of term human fetal membranes

Positive and negative effects of cellular senescence during female reproductive aging and pregnancy

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