Re: Effect of progestogen for women with threatened miscarriage: a systematic review and meta‐analysis

Renzo, Gian Carlo Di; Fonseca, Eduardo Borges da

doi:10.1111/1471-0528.16370

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…Nowadays, micronized progesterone products are largely preferred and used in obstetrics (and not only in this field) for many medical conditions, including threatened miscarriage, recurrent pregnancy loss and PTB prevention [ 26 , 33 , 34 ]. Based on the major part of consistent researches, the vaginal administration would be the best option to use due to the better concentrations that reach the uterus for the “first uterine pass effect” and to avoid the unwanted side effects such as nausea, headache, and sleepiness derived from oral route [ 26 , 35 ].…”

Section: Progesterone: Biochemical “Identikit” and Rationale For Usementioning

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: Biochemical “Identikit” and Rationale For Usementioning

confidence: 99%

Prevention of Preterm Birth with Progesterone

Renzo

Tosto

Цибизова

et al. 2021

JCM

Self Cite

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“…У цій роботі автори об'єднали 10 досліджень, що вивчали різні прогестагени, природний прогестерон та синтетичні прогестини з різними шляхами введення (наприклад, пер оральний дидрогестерон і вагінальний прогестерон). Варто зазначити, що кілька важливих обмежень і слабких сторін цього дослідження були чітко визначені самими авторами, і про них краще було б повідомити заздалегідь у рефераті, як підкреслювали Жан Карло Ді Ренцо та Едуардо Фонсека [7]. Дійсно, у висновках, зазначених у рефераті, навіть не йдеться про оцінку ризику упередженості.…”

Section: про якість метааналізівunclassified

Meta-analysis and randomized controlled studies: what clinicists should know to prevent regular and spontaneous miscarriages of unexplained genesis?

Piette

2021

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The etiopathology of recurrent miscarriage is a combination of various factors, including chromosomal defects, genetic or structural abnormalities, endocrine abnormalities, infections, immune dysfunction, thrombophilia disorders, antiphospholipid syndrome, and unexplained causes.It has long been known that progesterone is needed to maintain pregnancy and its physiological development. Insufficient progesterone secretion and its low level in the blood serum in early pregnancy is associated with the threat of miscarriage and loss of pregnancy at a later stage – up to 16 weeks of gestation. The effectiveness of the vaginal micronized progesterone (VMP) at a dose of 400 mg twice a day in the first trimester of pregnancy was evaluated in two recent large high-quality multicenter placebo-controlled studies, one of which included pregnant women with recurrent miscarriages of unexplained origin (PROMISE Trial), and the other study included women with early pregnancy loss (PRISM Trial). A key finding, pioneered in the PROMISE study and later confirmed in the PRISM study, was that VMP treatment associated with an increase in live births in line with the number of previous miscarriages. It has been shown that there is no evidence regarding safety concerns with natural micronized progesterone. Treatment with an VMP should be recommended for women with bleeding in early pregnancy and a history of one or more miscarriages. The recommended treatment regimen is 400 mg 2 times a day (800 mg/day) intravaginal, starting from the moment bleeding is detected up to 16 weeks of pregnancy.In the future, there remains uncertainty effectiveness and safety of alternative progestogens (dydrogesterone) for the treatment of women at high risk of threatened abortion and recurrent miscarriage. It is important that dydrogesterone is a synthetic progestin, its structure is significantly different from natural progesterone, and therefore it is necessary to unequivocally prove the short- and long-term safety of this drug before considering its use in clinical practice.

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Authors' reply re: Effect of progestogen for women with threatened miscarriage: a systematic review and meta‐analysis

Fang

2020

BJOG

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Re: Effect of progestogen for women with threatened miscarriage: a systematic review and meta‐analysis

Cited by 3 publications

References 6 publications

Prevention of Preterm Birth with Progesterone

Prevention of Preterm Birth with Progesterone

Meta-analysis and randomized controlled studies: what clinicists should know to prevent regular and spontaneous miscarriages of unexplained genesis?

Authors' reply re: Effect of progestogen for women with threatened miscarriage: a systematic review and meta‐analysis

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