Threatened preterm labour – analysis of the cytokine profile and progesterone treatment efficiency

Chmaj-Wierzchowska, Karolina; Olejniczak, Tomasz; Tuzel, J.; Niepsuj-Biniaś, Joanna; Kaczorowska, Izabela; Samara, Husam; Budna, Joanna; Dera-Szymanowska, Anna; Olejniczak, Katarzyna; Szymanowski, Krzysztof

doi:10.1080/14767058.2016.1186638

Cited by 3 publications

(2 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A number of studies with small sample sizes have suggested that progesterone use in singleton pregnancies in women with a history of preterm birth, or a short cervix, can be effective in reducing the risk of preterm labor, provided onset of labor has not occurred at doses ranging from 100 to 400 mg/d from mid-gestation onward. [4][5][6][7][8][9][10] Once arrested preterm labor begins, progesterone is no longer effective at delaying birth. 2,3,11 Recently, a large double-blind, placebo-controlled trial known as the OPPTIMUM trial with 587 neonates in the placebo versus 589 in the progesterone groups showed that there was no effect of vaginal progesterone on gestational age at the time of delivery in singleton pregnancies.…”

Section: Introductionmentioning

confidence: 99%

Administration of Progesterone Throughout Pregnancy Increases Maternal Steroids Without Adverse Effect on Mature Oligodendrocyte Immunostaining in the Guinea Pig

et al. 2018

View full text Add to dashboard Cite

Progesterone is administered to pregnant women at risk of premature labor, despite systematic reviews showing conflicting outcomes regarding its use, highlighting doubt over the effectiveness of the therapy. Progesterone can be rapidly metabolized into a number of steroids, but to date, there has been a lack of investigation into the fetal steroid profiles following administration and whether this impacts fetal neurodevelopment. The objective of this study was to determine the effect of progesterone treatment on allopregnanolone and cortisol levels in the fetus and on a marker of myelination in the fetal brain. We used a guinea pig model where pregnant dams were administered vehicle (β-cyclodextrin) or progesterone orally throughout pregnancy (GA29-61). Maternal and fetal fluids and tissues were collected at both preterm (GA61) and term (GA68) ages. Maternal and fetal progesterone and cortisol were analyzed by enzyme immunoassay and allopregnanolone by radioimmunoassay. Measurement of myelination of fetal brains (hippocampus, cingulum, and subcortical white matter) at preterm and term ages was performed by immunohistochemistry staining for myelin basic protein. We found that dams receiving progesterone had significantly elevated progesterone and cortisol concentrations, but there was no effect on allopregnanolone. Interestingly, the increased cortisol concentrations were not reflected in the fetuses, and there was no effect of progesterone treatment on myelination. Therefore, we conclude that in our guinea pig model, maternal administration of progesterone has no effect on cortisol levels or markers of mature oligodendrocytes in the fetus and suggest this is potentially due to the protective cortisol barrier in the placenta.

show abstract

Section: Introductionmentioning

confidence: 99%

Administration of Progesterone Throughout Pregnancy Increases Maternal Steroids Without Adverse Effect on Mature Oligodendrocyte Immunostaining in the Guinea Pig

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Preterm labor threatens the maternal and fetal health and life and is thus considered the most significant clinical challenge faced by obstetricians globally. [ 1 ] The incidence of preterm labor ranges from 8% to 10% globally, accounting for about 80% of neonatal morbidity. [ 2 3 ] India has a very high incidence (23.3%) of preterm labor and preterm delivery (10%–69%).…”

Section: Introductionmentioning

confidence: 99%

Oral nifedipine and parenteral isoxsuprine in arresting preterm labor: A comparative study

Ray

Kshirsagar

2022

J Family Med Prim Care

View full text Add to dashboard Cite

Objective: To compare the efficacy of oral nifedipine and parenteral isoxsuprine in arresting preterm labor. Considering the paucity of studies comparing these two agents, a comparative analysis is obligatory. Materials and methods: Eighty antenatal women in the gestational age range of 28–37 weeks, with regular uterine contractions, cervical dilatation ≤3 cm, and <50% cervical effacement, admitted with complaints of preterm labor pain were randomized to receive either 40 mg isoxsuprine or 20 mg nifedipine. Efficacy of the drugs was measured in terms of arrest of preterm labor, prolongation of pregnancy, and the days gained by infant before birth. Results: Isoxsuprine showed increased lowering of systolic blood pressure (SBP), diastolic blood pressure (DBP), and slightly higher maternal pulse rate, but higher fetal pulse rate post-administration in comparison to nifedipine ( P < 0.05). Isoxsuprine was significantly associated with more side effects. Pregnancy was more prolonged in the nifedipine group (25 days) than in the isoxsuprine group (19 days) ( P < 0.05). The birth weight of neonates in group B was more than that of neonates in group A ( P < 0.05). At 5 min after birth, none of the neonates in group B had an Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) abnormal score <7, compared to neonates in group A. Majority of neonates in group A showed tachycardia and respiratory distress syndrome (RDS) (17.5% and 12.5%, respectively), compared to group B (12.5% and 7.5%, respectively). The overall success rate was better in group B (86.8%) compared to group A (80%). Conclusion: Nifedipine was slightly more effective in arresting preterm labor with fewer side effects, compared to isoxsuprine.

show abstract

Effectiveness and Safety of Isoxsuprine Hydrochloride as Tocolytic Agent in Arresting Active/Threatened Preterm Labor and Its Role in Maintenance Tocolysis: A Prospective, Open-Label Study

Jaju

2019

Am J Perinatol

View full text Add to dashboard Cite

Objective The aim of the study is to obtain insights on the short and long-term safety and effectiveness of isoxsuprine hydrochloride as a tocolytic agent in the management of PTL. Study Design In this prospective, single-center, noncomparative study, patients (with preterm labor at gestational age of 24–37 weeks) were administered intravenous (IV) infusion of 40-mg isoxsuprine hydrochloride until uterine quiescence, followed by intramuscular (IM) injection of isoxsuprine hydrochloride 10 mg/4-hourly for first 24 hours and maintained with retard 40-mg sustained release capsule (two times a day) till the time of delivery or 37 completed weeks of pregnancy. Results All patients (n = 50) achieved successful tocolysis in 24 hours and 48 hours postadministration of isoxsuprine hydrochloride (IV/IM/oral). Mean (±SD) gestation age at the time of delivery was 39.8 ± 2.1 weeks, with latency period of 58.5 ± 18.7 days. Pregnancy outcomes were normal in all the patients and no congenital anomaly/fetal infection was reported. Mean (±SD) fetal birth weight was 2.7 ± 0.3 kg; mean (±SD) Apgar score at 1 and 5 minutes were 7.5 ± 0.6 and 9.2 ± 0.4, respectively. Maternal tachycardia and vomiting (8.0% each) were the commonly reported adverse drug reactions, which were resolved with dose adjustment. Conclusion Isoxsuprine was found to be an effective and well-tolerated tocolytic agent in arresting PTL, in turn resulting in the overall improvement in maternal and perinatal outcomes.

show abstract

Threatened preterm labour – analysis of the cytokine profile and progesterone treatment efficiency

Abstract: No statistically significant differences were found in the cytokine profile among those patients in normally progressing pregnancy or in threatened preterm labour. No suitability of progesterone treatment in threatened preterm labour was observed.

Cited by 3 publications

References 14 publications

Administration of Progesterone Throughout Pregnancy Increases Maternal Steroids Without Adverse Effect on Mature Oligodendrocyte Immunostaining in the Guinea Pig

Administration of Progesterone Throughout Pregnancy Increases Maternal Steroids Without Adverse Effect on Mature Oligodendrocyte Immunostaining in the Guinea Pig

Oral nifedipine and parenteral isoxsuprine in arresting preterm labor: A comparative study

Effectiveness and Safety of Isoxsuprine Hydrochloride as Tocolytic Agent in Arresting Active/Threatened Preterm Labor and Its Role in Maintenance Tocolysis: A Prospective, Open-Label Study

Contact Info

Product

Resources

About