scholarly journals Effectiveness of Vaginal versus Intramuscular Progesterone for the Prevention of Preterm Delivery

2016 ◽  
Vol 22 (4) ◽  
Author(s):  
Rabia Wajid ◽  
Maria Zafar ◽  
Fatima Waheed

<p><strong>Objective:  </strong>The objective was to compare the effectiveness of vaginal versus intramuscular progesterone to prevent preterm delivery in patients with history of preterm labor in previous pregnancy.</p><p><strong>Patients and Methods:</strong><strong>  </strong>It was a Randomized Control Trial carried out in the Gynecology Unit in a Public sector Hospital, Lahore from March to December 2015. A total of 800 patients were enrolled through Antenatal OPD and were randomly divided into two groups by draw method. In Group-A, patients were administered 200mg of vaginal progesterone pessary once daily and in Group-B 250 mg of intramuscular progesterone was injected weekly. Treatment was continued until 37 completed weeks of gestation. The patients were followed up through their contact numbers and on routine follow up. This practice was abandoned if premature rupture of membranes occurred and the fetus was delivered before 37 weeks. All the parameters were recorded by the researcher on proforma. The data was analyzed using Statistical Package for the Social Sciences (SPSS) version 16.0. Chi Square test was applied to draw the comparison.</p><p><strong>Results:</strong><strong>  </strong>The mean age of patients was 26.16 ± 5.36 years (18 – 35 years). The 296 patients were Para 1, 290 were Para 2, 142 were Para 3, 51 were Para 4 and 21 females were Para 5. In all females, the mean gestational age at time of presentation was 22.00 ± 1.47 weeks, whereas, at time of delivery, mean gestational age was 36.05 ± 2.38 weeks. In vaginal progesterone group, the mean gestational age at time of delivery was 36.67 ± 1.92 weeks while in IM group, mean gestational age at time of delivery was 35.43 ± 2.62 weeks. The difference between both groups was statistically significant (P &lt; 0.05). Effectiveness (delivery ≥ 37 weeks) was achieved in 379 (47%) cases, out of which 228 (57%) cases belonged to vaginal progesterone group and 151 (37.8%) cases belonged to IM progesterone group (P &lt; 0.05). Post stratification with age and parity also showed that vaginal progesterone is more efficacious than IM progesterone (P &lt; 0.05).</p><p><strong>Conclusion:</strong><strong>  </strong>We concluded that vaginal progesterone is more effective than intramuscular progesterone for the prevention of preterm labor in patients with history of preterm labor in previous pregnancy.<strong></strong></p>

Author(s):  
Khadija Shahzad ◽  
Tazeen Farhan ◽  
Sadia Ilyas

Background: Preterm birth is associated with many adverse outcomes and is defined as birth of a baby before 37 weeks of gestation. Around 15 million babies born preterm around the world with survival rates at different gestational like less 23 week, 23 weeks, 24 weeks and 25 weeks are 0%, 15%, 55% and 80% respectively. Progesterone has shown to reduce the incidence of preterm birth. Objective of the study was to find out frequency of preterm birth in patients (with previous history of preterm birth) treated with intramuscular progesterone.Methods: It was randomized controlled trial conducted in the department of Obstetrics and Gynecology, Unit-I, Sir Ganga Ram Hospital Lahore, Pakistan conducted from October 2017 to April 2018. It included 530 pregnant women with history of at least 1 previous preterm delivery presenting in antenatal clinic between 16-20 weeks of gestation. The lottery method was employed to segregate patients in two groups. Patients received intramuscular progesterone injection proluton depot 250 mg intramuscular weekly from 16-20 weeks till 37 weeks and other group received placebo drug.Results: Mean age was 27.52±4.57 years while the mean gestational age was 17.39±1.38 weeks. The mean gestational age at delivery was significantly higher among intramuscular group (36.14±2.23 versus 35.07±2.97 weeks; p=0.000). The frequency of preterm delivery was significantly lower in intramuscular group (24.9% versus 39.6%; p=0.000) as compared to placebo group.Conclusions: Frequency of preterm delivery was significantly lower in patients treated with intramuscular progesterone (24.9% versus 39.6%; p=0.000) irrespective of patients age, parity, BMI and number of previous preterm deliveries. 


2016 ◽  
Vol 8 (01) ◽  
Author(s):  
Tri Anasari ◽  
Ika Pantiawati

Tri Anasari1, Ika Pantiawati21) 2) Akademi Kebidanan YLPP PurwokertoE-mail: [email protected], [email protected]: Persalinan preterm merupakan persalinan belum cukup umur di bawah usia kehamilan 37 minggu dan berat bayi kurang dari 2500 gr. Dampak yang dapat ditimbulkan dari kejadian persalinan preterm antara lain hipotermi, asfiksia, ikterik, infeksi dan pertumbuhan retardasi janin. Dampak tersebut merupakan penyebab utama kematian pada bayi. Persalinan preterm di RSUD Margono Soekarjo dari tahun 2010-2013 terus meningkat. Tahun 2011 mengalami kenaikan 0,01%, tahun 2012 naik 3,32% dan tahun 2013 meningkat 3,4%. Tujuan penelitian ini adalah mengetahui faktor-faktor yang mempengaruhi persalinan preterm, meliputi usia, paritas, pekerjaan, status gizi dan riwayat kelahiran preterm di RSUD Prof. Dr. Margono Soekarjo Purwokerto. Metode penelitian: Jenis penelitian ini adalah survei analitik dengan pendekatan case control retrospektif. Populasi penelitian ini adalah seluruh ibu bersalin dari Januari-Desember 2013. Sampel dalam penelitian ini berjumlah 77 ibu bersalin preterm dan 77 ibu bersalin non preterm dengan total 154 responden, menggunakan teknik systematic random sampling. Analisis bivariat menggunakan uji chi square dan analisis multivariat menggunakan regresi logistik.Hasil penelitian: Sebagian besar usia, paritas, pekerjaan, riwayat persalinan preterm, dan status gizi tidak berisiko. Ada hubungan antara usia dengan persalinan preterm (p=0,004), ada hubungan paritas dengan persalinan preterm (p=0,001), ada hubungan pekerjaan dengan persalinan preterm (p=0,000), ada hubungan riwayat persalinan dengan persalinan preterm (p=0,000) dan ada hubungan status gizi dengan persalinan preterm (p=0,003). Kesimpulan: ada pengaruh secara bersama-sama antara usia, paritas, pekerjaan, riwayat persalinan dan status gizi dengan persalinan preterm di RSUD Prof. Dr. Margono Soekarjo Purwokerto.Kata Kunci: Persalinan Preterm, Usia, Paritas, Pekerjaan, Riwayat Persalinan, Status GiziFACTORS RELATED TO THE PRETERM LABOR IN HOSPITAL PROF. Dr. MARGONO PURWOKERTO ABSTRACTPreterm delivery is not old enough labor below 37 weeks gestation and birth weight less than 2500 gram. The impact that may result from the incidence of preterm labor include hypothermia, asphyxia, jaundice, infections and fetal growth retardation. The impact is a major cause of death in infants. Preterm labor in hospitals Margono Soekarjo of the year 2010-2013 continues to increase. The Year 2011 increased 0.01%, in 2012 rose 3.32% and in 2013 increased by 3.4%. The purpose of this study was to factors cause of preterm labor include age, parity, employment, nutritional status and a history of preterm birth in hospitals Prof. Dr. Margono Soekarjo Purwokerto. This type of research is analytic survey with a retrospective case control approach. The study population was all women giving bith from January to December 2013. The sample in this study amounted to 77 preterm birth mothers and 77 non preterm birth mothers with a total of 154 respondents, using systematic random sampling technique. Bivariate analysis using chi square test and multivariate analysis using logistic regression. Results: Most of age, parity, Employment, a history of preterm delivery, and nutritional status were not at risk. There is a corelation between age and preterm delivery (p = 0.004), there is a corelation of parity with preterm delivery (p = 0.001), there is an employment corelation with preterm delivery (p = 0.000), there is a corelation history of labor with preterm delivery (p = 0.000) and No correlation with preterm labor nutritional status (p = 0.003). Conclusion: there is an influence jointly between age, parity, employment, labor history and nutritional status and preterm delivery in hospitals Prof. Dr. Margono Soekarjo Purwokerto.Keywords: Preterm, Age, Parity, Employment, Labor History, Nutritional Status


Author(s):  
Khadija Shahzad ◽  
Hafiza Ateeqa Mubarak Ali ◽  
Urooj Anwar ◽  
Ayesha Haroon

Background: Globally, it has proven that preterm birth is associated with perinatal mortality to the extent of >75%, and >50% of perinatal and long term morbidity. Oral progesterone are easy to take but are less effective because of first pass hepatic metabolism leading to variable plasma levels while intramuscular progesterone carries the risk of swelling and bruising at injection site. The aim was to find out frequency of preterm birth in patients treated with oral versus intramuscular progesterone.Methods: Randomized controlled trial conducted in the department of obstetrics and gynecology, Sir Ganga Ram hospital Lahore, Pakistan conducted from 5 October 2017 to 4 April 2018. This study involved 530 pregnant women with history of at least 1 previous preterm delivery presenting in antenatal clinic between 16-20 weeks of gestation. Group I received oral progesterone 10 mg tablet duphaston BD from 20 weeks till 37 weeks. Group II received intramuscular progesterone injection proluton depot 250 mg IM weekly from 16-20 weeks till 37 weeks.Results: The mean age of the patients was 27.52±4.57 years while the mean gestational age was 17.39±1.38 weeks. 47.5% of the patients were para 2 followed by para 3 (32.3%) and para 1 (20.2%). The mean gestational age at delivery was significantly higher among intramuscular group (36.14±2.23 versus 35.07±2.97 weeks; p=0.000). The frequency of preterm delivery was significantly lower in intramuscular group (24.9% versus 39.6%; p=0.000) as compared to oral group.Conclusions: Frequency of preterm delivery was significantly lower in patients treated with intramuscular progesterone (24.9% versus 39.6%; p=0.000) as compared to oral progesterone.


1970 ◽  
Vol 10 (3) ◽  
pp. 177-180
Author(s):  
B Mahamuda ◽  
S Tanira ◽  
W Feroza ◽  
HA Perven ◽  
A Shamim

Context: Anaemia is a common pregnancy related disorder in Bangladesh that causes various maternal and fetal problems. A prospective study was designed to see the associated maternal factors and fetal outcome in different categories of anaemia and to compare with that of normal pregnancy. Methods: The study was carried out on 60 Bangladeshi women within 35-40 weeks of gestation. Among them, 20 with normal uncomplicated pregnancies were considered as control group or group A, another 27 having pregnancies with mild anaemia were considered as group B, and 13 having pregnancies with moderate anaemia were considered as group C. Severe anaemic mothers were considered as group D, but not found during the period of collection of data for this study. The mothers were selected as who were suffering from antenatal anaemia i.e. having heamoglobin level <10 gm/dl (mild, if <10 gm/dl; moderate, if <8 gm/dl; and severe, if <6 gm/dl) and control i.e. having heamoglobin level ≥10 gm/dl. The foetal outcome was observed and recorded after delivery. Results: The mean age of the mother was 23.65±3.83 years, 27.26±4.93 years and 25.85±4.62 years and the mean number of gravidity was 1.65±0.67, 2.15±0.72 and 2.69±1.03 in group A, group B and group C respectively. The difference was statistically highly significant in between A and C (p<0.001) and also significant in between A & B and B & C (p<0.05). The mean gestational age of the mother was 38.65±0.88 weeks, 37.37±1.01 weeks and 37.15±1.28 weeks in group A, group B and group C respectively and the difference was statistically significant between A & B and A & C (p<0.001). The mean birth weight of the neonate was 3.09±0.30 Kg., 2.99±0.16 Kg. and 2.95±0.21 Kg., while the mean APGAR score of the neonate at first minute of birth was 8.90±1.07, 8.11±0.89 and 7.69±0.48 in group A, group B and group C respectively. No significant difference was found in birth weight of the newborn babies in between the groups of the mothers. However, the difference was found significant in between A & B (p<0.01) and A & C (p<0.001), in case of APGAR score. Key words: Maternal anaemia, gestational age, neonatal outcome, birth weight, APGAR score. DOI: http://dx.doi.org/10.3329/bjms.v10i3.8361 BJMS 2011; 10(3): 177-180


Author(s):  
Malathi T. ◽  
Sowmya Sampurna Maddipati

Background: The objective of present study was to measure the serum magnesium levels in preterm labor patients, to measure the serum magnesium levels in term labor patients and to correlate the serum magnesium levels in preterm and term labor patients.Methods: It is a prospective case control study conducted in the department of obstetrics and gynecology, KIMS hospital and research Centre, Bengaluru, Karnataka, India. A venous blood sample is drawn from patients admitted to labor room who fulfill the inclusion and exclusion criteria out of which 50 patients belong to the Group-A (preterm labor) and 50 patients belong to Group-B (term labor). Serum magnesium level is measured in both the groups.Results: Women with preterm labor had a significantly reduced serum magnesium level with a mean serum magnesium level of 1.59 mg/dl with a SD of 0.83 whereas the patients with term labor had a mean serum magnesium level of 2.55 mg/dl with a SD of 0.40. The difference of serum magnesium levels observed between the study population and control population is independent of factors like maternal age, parity, gestational age, and socio-economic factors. In this study, it is found that serum magnesium levels are lower in early and late preterm compared to preterm between 33-34+6 weeks.Conclusions: Serum magnesium level can be used as a predicting tool for preterm labor. Preterm labor can be avoided by simple supplementation of Magnesium which might provide an easy and inexpensive means to decrease the problems related to preterm labor. There is a further scope for research on serum magnesium levels based on gestational age.


2016 ◽  
Vol 214 (1) ◽  
pp. S218
Author(s):  
Patrick Rozenberg ◽  
Thibaud Quibel ◽  
Mireille Ruiz ◽  
Claire Thuillier ◽  
Marion Thaillez

Author(s):  
Erwin Purba

Objective: To know the difference of salivary estriol level between patients with preterm birth and preterm pregnancy of 32-36 weeks and to determine the correlation between the level of estriol in saliva and the incidence of preterm delivery. Methods: This research was a cross-sectional studies of 80 patients in Dr. Hasan Sadikin Hospital and its networks. The subjects are 40 patients in labor and 40 patients in preterm pregnancy, that met the inclusion criterias during the period September 2011 to November 2011. We took the salivary sample and examine the level of estriol. The data were analyzed by Shapiro-Wilk and Mann Whitney test. Result: The study found that the difference of salivary estriol levels in preterm labor and preterm pregnancy groups was statistically significant (p<0.05). The mean salivary estriol levels in preterm labor group was 3438.75 while the mean value of estriol levels in preterm pregnancy group was 686.10 and ranges of each group is 1188-16338 and 88-1180. Conclusion: The value of salivary estriol levels were higher in preterm labor compared to the level in preterm pregnancy. [Indones J Obstet Gynecol 2012; 36-2: 66-70] Keywords: preterm labor, salivary estriol


2010 ◽  
Vol 2 (2) ◽  
pp. 129-131
Author(s):  
MS Nanavati ◽  
SV Desai ◽  
PD Lakhani ◽  
AS Bansode

ABSTRACT Objectives 1. To evaluate the mean cervical length at 22 to 28 weeks of gestation by TAS and TVS and correlate its association with preterm labor. 2. To compare the difference in cervical length measured by the above two methods. Methods This was a prospective trial involving 100 pregnant women spanning a period of ten months. Results Eighteen women out of the 100 studied had preterm labor; of which 17 had a cervical length of less than 3 mm at 22 to 28 weeks. The percentage of women with preterm delivery with a short cervix was 83% by transabdominal scan (TAS) and 94% with transvaginal scan (TVS). Conclusion The mean cervical length was lesser amongst women who had a preterm delivery as compared to those with a term delivery. The mean cervical length by TAS was more than that by TVS thereby suggesting that TVS has a higher sensitivity for detection of preterm labor than TAS.


2020 ◽  
Vol 33 (1) ◽  
pp. 41-47
Author(s):  
Mohsena Akhter ◽  
Ishrat Bhuiyan ◽  
Zulfiqer Hossain Khan ◽  
Mahfuza Akhter ◽  
Gulam Kazem Ali Ahmad ◽  
...  

Background: Scabies is one of the most common skin diseases in our country. It is caused by the mite Sarcoptes scabiei var hominis, which is an ecto-parasite infesting the epidermis. Scabies is highly contagious. Prevalence is high in congested or densely populated areas. Individuals with close contact with an affected person should be treated with scabicidal which is available in both oral and topical formulations. The only oral but highly effective scabicidal known to date is Ivermectin. Amongst topical preparations, Permethrin 5 % cream is the treatment of choice. Objective: To evaluate the efficacy & safety of oral Ivermectin compared to topical Permethrin in the treatment of scabies. Methodology: This prospective, non-randomized study was conducted at the out-patient department of Dermatology and Venereology of Shaheed Suhrawardy Medical College & Hospital over a period of 6 months, from August 2016 to January 2017. The study population consisted of one hundred patients having scabies, enrolled according to inclusion criteria. They were divided into two groups. group A was subjected to oral Ivermectin and the group B to Permethrin 5% cream. Patients were followed up on day 7 and 14 for assessment of efficacy and safety. Result: The mean scoring with SD in group A (Ivermectin) and group B (Permethrin) were 8.26 ± 2.22 and 7.59 ± 2.01 respectively at the time of observation. The difference between the mean score of the two group is not significant (p=0.117) the mean scoring with SD in group A and group B were 4.54 ± 2.05 and 1.64 ± 1.84 respectively at 7thdays. The difference between the mean score of the two group is significant (p<0.001). The mean scoring with SD in group A and group B were 2.68± 2.35 and .36± 1.10 respectively at 14th day difference between the mean score of the group is significant (p<0.001). Conclusion: Topical application of permethrin 5% cream is more effective and safer than oral Ivermectin in the treatment of scabies. TAJ 2020; 33(1): 41-47


2016 ◽  
Vol 8 (4) ◽  
pp. 158
Author(s):  
Abolfazl Zolfaghari

<p>Cheating and academic dishonesty is a moral anomaly in the field of scientific research and reflecting, i.e., academic environment and studies show that this phenomenon in many of the worlds is important problem.</p><p>This study measured the dishonesty of students in a quasi-experimental design. For this purpose, features lack of integrity by manipulating the facts were examined and meanwhile first, basic English language test coordination between the strict terms of the 280 students come to practice and after correction of examination papers by teachers, without leaving any traces on them instead, the plates are returned to students and provide them with answers to their paper to correct their score Master announced. The difference between the actual score (score of master) and score of the students to have their own, amount of honesty or lack of integrity appointed them and its relationship with some demographic and socio-ethical characteristics have been studied.</p><p>The results showed that more than 62 percent of the students in your grade to master completely honest with 26.6 percent have low honesty and the rest did not have the necessary integrity and the mean difference of scores announced by the professors and students have been about two score. Also results of chi-square tests and gamma, about the relationship between students’ evaluation of amount of sincerity with sincerity in the declared objective amount of the master score was not significant, this finding means that between demonstrators and people of integrity and honesty in practice, there are gaps.</p>


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