scholarly journals Vaginal progesterone decreases preterm birth ≤ 34 weeks of gestation in women with a singleton pregnancy and a short cervix: an updated meta‐analysis including data from the OPPTIMUM study

2016 ◽  
Vol 48 (3) ◽  
pp. 308-317 ◽  
Author(s):  
R. Romero ◽  
K. H. Nicolaides ◽  
A. Conde‐Agudelo ◽  
J. M. O'Brien ◽  
E. Cetingoz ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Meta Analysis ◽  
Singleton Pregnancy ◽  
Short Cervix ◽  
Vaginal Progesterone

scholarly journals Vaginal progesterone for prevention of preterm birth in asymptomatic high-risk women with a normal cervical length: a systematic review and meta-analysis protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Kimberley P. Williams ◽  
Liam McAuliffe ◽  
Rosanna Diacci ◽  
Anne-Marie Aubin ◽  
Ashad Issah ◽  
...  
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Meta Analysis ◽  
Cervical Length ◽  
Analysis Model ◽  
Spontaneous Preterm Birth ◽  
Singleton Pregnancy ◽  
Short Cervix ◽  
High Risk Women ◽  
Vaginal Progesterone

Abstract Background Preterm birth (PTB) is estimated to affect 14.9 million babies globally every year. Global rates of PTB continue to increase from 9.8 to 10.6% over a 15-year period from 2000 to 2014. Vaginal progesterone is commonly used by clinicians as a prevention strategy, with recent evidence affirming the benefit of vaginal (micronised) progesterone to prevent PTB in women with a shortened cervix (< 25 mm). Given the low incidence of a short cervix at mid-gestation in high-risk populations further evidence is required. The objective of this review is to determine if vaginal progesterone reduces spontaneous preterm birth (sPTB) before 37 weeks in asymptomatic high-risk women with a singleton pregnancy with a normal mid-gestation cervical length. Methods Studies will be sourced from MEDLINE, Embase and Cochrane Register of Trials (CENTRAL) from their inception onwards with the search terms ‘progesterone’ and ‘preterm birth’. Studies will be screened and included if they assess vaginal progesterone compared to placebo in women with a normal cervical length. The primary outcome will be sPTB < 37 weeks, with secondary outcomes of sPTB < 34 weeks. Two independent reviewers will conduct study screening at abstract and full text level, data extraction and risk of bias assessment with disagreements resolved by an experienced researcher. The Mantel-Haenszel statistical method and random effects analysis model will be used to produce treatment effect odds ratios and corresponding 95% confidence intervals. Discussion This review will assess the current body of evidence and provide clarity regarding the potential benefits and best practice of use of vaginal progesterone in asymptomatic women with high-risk singleton pregnancies and normal cervical length. Trial registration PROSPERO CRD42020152051

scholarly journals Vaginal Progesterone for Prevention of Preterm Birth in Asymptomatic High-Risk Women with a Normal Cervical Length: A Systematic Review and Meta-Analysis Protocol

2020 ◽  
Author(s):  
Kimberley Paige Williams ◽  
Liam McAuliffe ◽  
Rosanna Diacci ◽  
Anne-Marie Aubin ◽  
Ashad Issah ◽  
...  
Keyword(s):  
Preterm Birth ◽  
High Risk ◽  
Meta Analysis ◽  
Cervical Length ◽  
Analysis Model ◽  
Spontaneous Preterm Birth ◽  
Singleton Pregnancy ◽  
Short Cervix ◽  
High Risk Women ◽  
Vaginal Progesterone

Abstract Background: Preterm birth (PTB) is estimated to affect 14.9 million babies globally every year. Global rates of PTB continue to increase from 9.8% to 10.6% over a 15-year period from 2000 to 2014. Vaginal progesterone is commonly used by clinicians as a prevention strategy, with recent evidence affirming the benefit of vaginal (micronized) progesterone to prevent PTB in women with a shortened cervix (<25mm). Given the low incidence of a short cervix at mid-gestation in high-risk populations further evidence is required. The objective of this review is to determine if vaginal progesterone reduces spontaneous preterm birth (sPTB) before 37 weeks in asymptomatic high-risk women with a singleton pregnancy with a normal mid-gestation cervical length. Methods: Studies will be sourced from MEDLINE and Embase databases with the search terms “progesterone” and “preterm birth”. Studies will be screened and included if they assess vaginal progesterone compared to placebo in women with a normal cervical length. The primary outcome will be sPTB <37 weeks, with secondary outcomes of sPTB <34 weeks. Two independent reviewers will conduct study screening at abstract and full text level, data extraction and risk of bias assessment with disagreements resolved by an experienced researcher. The Mantel-Haenszel statistical method and random effects analysis model will be used to produce treatment effect odds ratios and corresponding 95% confidence intervals.Discussion: This review will assess the current body of evidence and provide clarity regarding the potential benefits and best practice of use of vaginal progesterone in asymptomatic women with high risk singleton pregnancies and normal cervical length. Trial registration: This study has been registered on PROSPERO with the registration number CRD42020152051

scholarly journals Vaginal progesterone in risk reduction of preterm birth in women with short cervix

2019 ◽  
Vol 8 (7) ◽  
pp. 2695
Author(s):  
Shubhi Srivastava ◽  
D. Borgohain
Keyword(s):  
Preterm Birth ◽  
Transvaginal Ultrasound ◽  
Perinatal Outcomes ◽  
Cervical Length ◽  
Singleton Pregnancy ◽  
Short Cervix ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Vaginal Progesterone ◽  
Adverse Neonatal Outcomes

Background: Preterm birth is a global health problem affecting the neonate, family and country in general. It is the leading cause of perinatal mortality and morbidity. Short cervical length detected on transvaginal ultrasound is the most practical risk factor for prediction of preterm birth. The aim of this study was to determine the efficacy and safety of vaginal progesterone in reducing the rate of preterm birth in women with a short cervix and to determine its effect on neonatal mortality and morbidity.Methods: The study was carried out in the Department of Obstetrics and Gynaecology at Assam Medical College, Dibrugarh for a period of one year. It included 128 asymptomatic women with a singleton pregnancy and a sonographic short cervix. Women were randomly divided into two groups, one of which was given placebo and the other was given vaginal progesterone and a comparative study was conducted.Results: It was observed that delivery before 37 weeks of gestation was less frequent in the progesterone group than in the placebo group (60.94% vs. 90.63%). Vaginal progesterone was also associated with a significant reduction in adverse neonatal outcomes like the rate of sepsis (6.25% vs. 18.75%), requirement of ventilator (12.5% vs. 26.56%), admission to NICU (10.94% vs. 26.56%) and birth weight ≤1.5kg (7.81% vs. 21.88%).Conclusions: Vaginal progesterone reduces the risk of preterm birth and adverse perinatal outcomes in pregnant women without any deleterious effects on the foetus or mother.

scholarly journals Effectiveness of combined vaginal progesterone and cervical cerclage in preventing preterm birth: a systematic review and meta-analysis protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050086
Author(s):  
Rosanna C Diacci ◽  
Ashad Issah ◽  
Kimberley P Williams ◽  
Liam McAuliffe ◽  
Anne-Marie Aubin ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Fixed Effects ◽  
Combined Therapy ◽  
Combined Treatment ◽  
Cochrane Library ◽  
Publication Date ◽  
Singleton Pregnancy ◽  
Cervical Cerclage ◽  
Short Cervix ◽  
Vaginal Progesterone

IntroductionPreterm birth (PTB) is the leading cause of death in children under 5 years. Preventive therapies targeted towards women with risk factors such as a prior PTB or a short cervix reduce the rate of PTB. Cervical cerclage, vaginal progesterone and a combination of the two have been used with no consensus as to whether combined treatment is more effective than any single treatment alone. The objective of this review is to determine the efficacy of combined treatment compared with cerclage alone and combined treatment compared with progesterone alone.Methods and analysisStudies will be sourced from the electronic databases Medline (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Scopus, CINAHL (EBSCOhost) and Cochrane Library (Wiley) and reference lists. We will not exclude any papers due to publication date. Randomised control trials (RCTs), non-RCTs and cohort studies assessing single therapy (either progesterone or cerclage) versus combined therapy in women with a singleton pregnancy will be included. Two independent reviewers will conduct study screening (at abstract and full-text level), data extraction and risk of bias assessment with disagreements resolved by an experienced researcher. Random or fixed effects models will be used depending on data heterogeneity and data will be presented as risk ratio for dichotomous data or mean difference for continuous data with a CI of 95% used for all outcomes.Ethics and disseminationNot applicable due to nature of the study type.PROSPERO registration numberCRD42020195975.

Safety and efficacy of the cervical pessary combined with vaginal progesterone for the prevention of spontaneous preterm birth

2018 ◽  
Vol 46 (5) ◽  
pp. 531-537 ◽  
Author(s):  
Georgios Daskalakis ◽  
Dimitrios Zacharakis ◽  
Marianna Theodora ◽  
Panagiotis Antsaklis ◽  
Nikolaos Papantoniou ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Combined Treatment ◽  
Primary Outcome Measure ◽  
Perinatal Complications ◽  
Spontaneous Preterm Birth ◽  
Singleton Pregnancy ◽  
Short Cervix ◽  
Safety And Efficacy ◽  
Cervical Pessary ◽  
Vaginal Progesterone

AbstractIntroduction:The aim of this study was to evaluate the safety and efficacy of the combined treatment of cervical pessary and endovaginal progesterone for the prevention of spontaneous preterm birth (SPB) in women with a short cervical length (CL) between 20 and 24 weeks of gestation.Materials and methods:This is a prospective study of women with a singleton pregnancy and a sonographically detected mid-trimester CL ≤25 mm. The primary outcome measure was spontaneous delivery before 34 weeks (238 days) of gestation.Results:The study sample consisted of 90 women with a mean CL of 14.2 mm (SD=6.5 mm). Of the women, 34.4% had at least one risk factor for SPB; 7.8% delivered preterm before 34 weeks of gestation, and 25.6%, before 37 weeks. Neonatal death occurred in two (2.2%) cases due to respiratory distress syndrome. Lower body mass index values, history of preterm delivery and number of second trimester miscarriages were independently associated with delivery before 34 weeks.Conclusion:The combination of vaginal progesterone and cervical pessary for the prevention of SPB in women with a short cervix is safe and well tolerated. This therapy was associated with pregnancy prolongation, reduced prematurity rate and a low rate of perinatal complications.

Sign in / Sign up

Export Citation Format

Share Document