Vaginal progesterone after tocolytic therapy in threatened preterm labor

Bomba‐Opoń, Dorota; Kosińska-Kaczyńska, Katarzyna; Kosiński, Przemysław; Węgrzyn, Piotr; Kaczynski, Bartosz; Wielgoś, Mirosław

doi:10.3109/14767058.2011.629014

Cited by 20 publications

(23 citation statements)

References 14 publications

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“…Recently, in a nonrandomised, retrospective study, Bomba‐Opon et al . reported a strong effect of vaginal progesterone in women with PTL.…”

Section: Discussionmentioning

confidence: 99%

“…However, its effectiveness in women with PTL has been less well evaluated with conflicting results reported. Several small and unblinded clinical studies have reported a beneficial effect of natural progesterone or 17‐hydroxyprogesterone caproate (17P) in reducing the duration of tocolysis treatment and preventing PTB . Nevertheless, the largest study published to date found no efficacy for the prevention of PTB with the use of 17P .…”

Section: Introductionmentioning

confidence: 99%

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Prevention of preterm delivery with vaginal progesterone in women with preterm labour (4P): randomised double‐blind placebo‐controlled trial

Tejada

Karolinski

Ocampo

et al. 2014

BJOG

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Objective To evaluate the effectiveness of 200 mg of daily vaginal natural progesterone to prevent preterm birth in women with preterm labour.Design Multicentre, randomised, double-blind, placebo-controlled trial.Setting Twenty-nine centres in Switzerland and Argentina.Population A total of 385 women with preterm labour (24 0/7 to 33 6/7 weeks of gestation) treated with acute tocolysis.Methods Participants were randomly allocated to either 200 mg daily of self-administered vaginal progesterone or placebo within 48 hours of starting acute tocolysis.Main outcome measures Primary outcome was delivery before 37 weeks of gestation. Secondary outcomes were delivery before 32 and 34 weeks, adverse effects, duration of tocolysis, re-admissions for preterm labour, length of hospital stay, and neonatal morbidity and mortality. The study was ended prematurely based on results of the intermediate analysis.

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“…Recently, in a nonrandomised, retrospective study, Bomba‐Opon et al . reported a strong effect of vaginal progesterone in women with PTL.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevention of preterm delivery with vaginal progesterone in women with preterm labour (4P): randomised double‐blind placebo‐controlled trial

Tejada

Karolinski

Ocampo

et al. 2014

BJOG

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show abstract

“…[19][20][21][22][23][24][25][26][27][28][29][30] But there are few studies regarding role of progesterone in threatened PTL. [34][35][36][37][38][39] Most of the studies compared the effect of progesterone as a maintainance tocolytic with placebo after initial tocolysis with other agents. There are very few studies compairing the different routes of use of progeterone.…”

Section: Results and Analysismentioning

confidence: 99%

Comparative Study to Assess the Efficacy Between Intramuscular and Vaginal Micronized Progesterone to Prevent Threatened Premature Labour

Patra¹,

Chattopadhyay²,

Munsi³

et al. 2015

jemds

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Preterm birth remains a major clinical problem. Prematurity is not only a major cause of perinatal mortality but also leads to greater risk for short and long term complications including disability and impediments in growth and mental development. To compare vaginal with intramuscular progesterone administration to prevent preterm labor and to detect the effect of both on the uterine and foetal circulations. STUDY DESIGN: comparative interventional study. POPULATION: 100 pregnant women attending NRSMCH Kolkata, Obstetrics emergency with threatened preterm labour before 34 weeks of gestation. STUDY PERIOD: one year. METHODS: Gestational age was confirmed clinically and by USG of early weeks of gestation. Efficacy and tolerability of progesterone in two routes i.e., intramuscular and vaginal for prevention of threatened preterm labour were compared. OUTCOME: Ante partum, intrapartum and perinatal outcomes were compared between two groups by statistical analysis of data's using chi-square test and student-t test. CONCLUSION: Vaginal progesterone was as effective as intramuscular progesterone in reducing preterm birth with fewer side effects in favor of vaginal route.

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“…In various studies improvement in birth weight ranged from 290-490 gms. 11,[13][14][15]18 NICU admission were also less in study group(14% vs 24%) with shorter nursery stay(7.71 vs 8.41 days).Neonatal complications like RDS, sepsis, mechanical ventilation were also less in study group. There was one case of neonatal death in Group II.…”

Section: Discussionmentioning

confidence: 72%

“…Results are similar as reported in literature though progesterone, dose and route are different in various studies. 11,[13][14][15][16] Borna et al reported difference in prolongation of pregnancy by 11.5 days while Gargari et al reported it to be 2.6 weeks. Bomba-Opon et al observed a significant reduction in delivery before 34 weeks with vaginal progesterone (9.8% in progesterone group versus 35.3% in control group; p = 0.002).…”

Section: Discussionmentioning

confidence: 99%

The role of micronized progesterone in preterm labour

2020

IJOGR

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Objective: To study the role of intravaginal micronized progesterone in preterm labour in prolonging the pregnancy up to term and thus improving neonatal outcome Materials and Methods: A prospective randomized study wherein 100 pregnant women between 26-34 weeks of pregnancy admitted to labour ward with s/s of preterm labour were included in the study. After initial management with tocolytics and antenatal steroids, when the labour got arrested these women were randomly divided into two groups 1and 2. Group 1 received 200 ug of intravaginal micronized progesterone from inclusion in the study to 36 weeks or till delivery whichever was earlier.Group 2 received only supportive therapy. None of women received oral tocolytics after initial arrest of labour. All women were followed up till delivery and obstetric outcome noted Primary variables were prolongation of pregnancy from inclusion in study to delivery interval, gestation age at delivery. Neonatal outcome variables were birth weight, need for NICU transfer, length of stay in NICU and neonatal complications The results observed were subjected to statistical analysis by SPSS-13 unpaired student t-test, Mann-Whitney for quantitative variables and Chi-square/fisher exact for qualitative variables Results: The two groups were comparable in term of age, parity and rural/urban status. Baseline presentation characteristics of the two groups such as period of gestation, number of uterine contractions per 10 minutes, cervical dilatation and, cervical effacement were also comparable (p value <0.05). Mean gestational age at delivery in group 1 was significantly more than group 2 (36.808 weeks vs. 34.078 weeks). Patient delivering beyond 37 weeks of gestation were significantly more in group 1 (60%vs 14%). Prolongation of pregnancy was significantly more in group 1, mean no. of days being 34±15.25 and 24.22±12.73 in group 1 & 2 respectively. Neonatal outcome in terms of birth weight was significantly better in group 1.mean birth weight being 2675.2±382.20 and 2393.2±378.05 in group1 and 2 respectively. Neonatal complications in terms of need for NICU admission, RDS, sepsis and mechanical ventilation were more in group 2. Conclusion: In preterm labour once the labour is arrested with tocolytics, intravaginal micronized progesterone therapy is effective in prolonging the pregnancy and thus increasing the gestational age at delivery. Neonatal outcome is improved because of increased birth weight and lesser complications.

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Vaginal progesterone after tocolytic therapy in threatened preterm labor

Abstract: The administration of vaginal progesterone after tocolysis in threatened preterm labor is associated with prolongation of pregnancy. The reduction of deliveries before 34 weeks was observed in patients presenting with contractions after 27 weeks gestation.

Cited by 20 publications

References 14 publications

Prevention of preterm delivery with vaginal progesterone in women with preterm labour (4P): randomised double‐blind placebo‐controlled trial

Prevention of preterm delivery with vaginal progesterone in women with preterm labour (4P): randomised double‐blind placebo‐controlled trial

Comparative Study to Assess the Efficacy Between Intramuscular and Vaginal Micronized Progesterone to Prevent Threatened Premature Labour

The role of micronized progesterone in preterm labour

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