Treatment of preterm labor with human chorionic gonadotropin: a new modality

Ali, Asifa

doi:10.1016/s0029-7844(00)00718-3

Cited by 12 publications

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“…Whole hCG exhibited potent inhibition of prostaglandin (PGF 2 alpha)‐induced preterm delivery in mice and the effect was dose‐dependant 6 . A preliminary study which involved administration of hCG or placebo to women in preterm labour reported significant improvement in terms of prolongation of pregnancy and smaller numbers of infants with birthweights less than 2500g in the treatment group 12 . While the results from our study demonstrate that hCG exerts substantial myometrial inhibition (circa 60% at bath concentration of 10 iu/mL) this inhibitory effect is of lesser magnitude than that reported in vitro for known pharmacological utero‐relaxant agents such as beta adrenergic agonists 13 , calcium channel blockers 13 , nitric oxide donor compounds 14 or potassium channel openers 8 , which exert close to 100% inhibition at maximum bath concentrations.…”

Section: Discussionmentioning

confidence: 99%

“…Recent in vivo studies in animal models have suggested that hCG is a potent inhibitor of induced preterm delivery raising the question about its potential future role for tocolysis in human preterm labour 6 . While recent preliminary reports have demonstrated the efficacy of hCG in the treatment of human preterm labour 7 there are no data outlining the in vitro effects of hCG on human myometrium during pregnancy. The primary aim of this study was to evaluate the effect of hCG on human myometrial contractility in pregnancy and to quantify its possible utero‐relaxant potency.…”

Section: Introductionmentioning

confidence: 99%

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Human chorionic gonadotrophin inhibition of pregnant human myometrial contractility

Slattery

Brennan

O’Leary

2001

BJOG

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Objective To evaluate the effect of human chorionic gonadotrophin (hCG) on pregnant human myometrial contractility in vitro and to determine whether the hCG-elicited effect was oestrogen dependant. Methods Isometric tension recording was performed under physiological conditions in isolated myometrial strips from biopsies obtained at elective caesarean section. The effect of cumulative additions of hCG (0.001, 0.01, 0.1, 1.0 and 10 iu/mL) on myometrial contractility was evaluated. Secondarily, the contractile activity of pregnant myometrium following hCG exposure was investigated in tissue pre-treated with beta-oestradiol.Results hCG exerted a statistically signi®cant relaxant effect on pregnant human myometrial tissue. The relaxant effect increased with increasing concentrations of hCG from 8.96% (SEM 2.06) (0.001 iu/mL hCG; P , 0.01) to a net cumulative total of 58.50% (SEM 3.74) (10 iu/mL hCG; P , 0.01). The relaxant effect was also timedependant, increasing in magnitude throughout the duration of experiments. Beta-oestradiol did not signi®-cantly affect the response of myometrial tissue to hCG.Conclusions These results clearly demonstrate that hCG exerts a signi®cant concentration-dependant relaxant effect on human myometrial tissue obtained rate in pregnancy. These ®ndings outline an inhibitory physiological role of hCG on human myometrial contractility and raise the possibility of its potential use as a tocolytic.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Human chorionic gonadotrophin inhibition of pregnant human myometrial contractility

Slattery

Brennan

O’Leary

2001

BJOG

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“…may be an ideal candidate for the therapy of preterm labour[17].Ali et al, observed the mean prolongation of 28.8 days in H.C.G. treated group versus 15 days in placebo treated group, which was statistically significant difference between the two groups(p value<0.001), thus concluding that it exhibits potent tocolysis with no fetal side effects, when compared to placebo[18].…”

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confidence: 99%

H.C.G (Human Chorionic Gonadotropin) versus Magnesium sulphate in suppression of preterm labour

Goswami¹,

Agrawal²

2015

Int J Med Res Rev

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Section: -12mentioning

confidence: 99%

“…[8][9][10][11][12] The studies on women with active labor were compared with MgSO 4 treatment. [8][9][10][11] The results showed that while hCG was equally effective, it did not have the side effects of MgSO 4 . [8][9][10][11] In the prophylactic study, hCG was found to be equally effective as vaginal micronized progesterone tablets with a better compliance rate than progesterone.…”

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confidence: 99%

It is Time to Evaluate Human Chorionic Gonadotropin for the Treatment of Preterm Births

Rao¹

2015

Women Health Open J

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Births between 20th to 37 th completed gestational weeks are considered preterm. More births occur during late (34-36 weeks) than in early (before 34 weeks) preterm period. Preterm births account for more infant deaths than any other cause. The prematurely born infants have breathing problems, feeding difficulties, cerebral palsy, developmental delays, vision problems and hearing impairment. These complications are generally more severe in early than in late preterm born infants. Preterm infants require medical care in neonatal intensive care units for several weeks after birth. The surviving infants are at a greater risk for early death and life-long neurological and cognitive difficulties. All this medical care costs billions of US healthcare dollars. In addition, parents go through considerable amount of guilt and emotional trauma.The incidence of preterm births is about 9% in US and higher in third world countries. Despite the basic science and clinical research advances to better understand and control preterm births, the rates are increasing. The current therapies include β-androgenic agonists, calcium channel blockers, non-steroidal anti-inflammatory compounds, nitric oxide donors, oxytocin antagonists, etc. Among them Magnesium sulfate (MgSO 4 ) is a popular first line therapy. Most of these drugs are only used for about 24-48 hours, so that the patients can be treated with corticosteroids to promote fetal lung maturity. The infants with relatively mature lungs have better survival chances. There is a clear unmet need to improve upon the current therapies to better control and treat preterm births.The paradigm shift on human chorionic gonadotropin (hCG) actions revealed that it can act on human myometrium.1 It contains hCG/luteinizing hormone receptors and their activation results in an inhibition of contractions.1-5 These findings are consistent with the notion that hCG promotes myometrial quiescence, which is a prerequisite for pregnancy initiation and continuation. 5 The quiescence declines as pregnancy advances, which permits myometrial stimulants to dominate so that they can facilitate normal labor progression. 5 The maintenance of myometrial quiescence by hCG suggests, that it could be used for suppression of prematurely activated myometrial contractions, that are responsible for preterm births. 5,6 In fact, hCG has been shown to be effective in preventing preterm birth in a mouse model. 7There are now five clinical studies testing hCG in the treatment of preterm births. 8-12Four of them were on women with active labor and the fifth was on women with a previous history of preterm births. [8][9][10][11][12] The studies on women with active labor were compared with MgSO 4 treatment. [8][9][10][11] The results showed that while hCG was equally effective, it did not have the side effects of MgSO 4 . [8][9][10][11] In the prophylactic study, hCG was found to be equally effective as vaginal micronized progesterone tablets with a better compliance rate than progesterone. 12Despite this encouraging data, t...

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Treatment of preterm labor with human chorionic gonadotropin: a new modality

Cited by 12 publications

References 0 publications

Human chorionic gonadotrophin inhibition of pregnant human myometrial contractility

Human chorionic gonadotrophin inhibition of pregnant human myometrial contractility

H.C.G (Human Chorionic Gonadotropin) versus Magnesium sulphate in suppression of preterm labour

It is Time to Evaluate Human Chorionic Gonadotropin for the Treatment of Preterm Births

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