Oral Allylestrenol: A Pregnancy-supporting Progestogen

ABSTRACT Allylestrenol is a synthetic progestogen that has been in therapeutic use in the management of mild to severe cases of certain obstetric complications, like selected forms of miscarriage/abortion, threatened preterm labor, intrauterine growth restriction (IUGR), and gestational hypertension. Natural progesterone may be used for treatment; however, it has the property of being rapidly metabolized in the liver besides having little or no oral activity. While there are many other synthetic and orally administrable progesterone analogs in the market, most of them, which are 19-nortestosterone derivatives, possess various undesirable side effects like symptoms of intolerance and a tendency to virilization. Allylestrenol, despite being a 19-nortestosterone derivative, has no known side effects including those attributed to the other members of its class, which is theorized to be due to subtle differences in its chemical structure, giving it a unique mechanism of action consisting of a triple effect—trophoblastic, placentotropic, and β2-adrenergic. The present review is mainly aimed at understanding the whys and wherefores behind the molecule's moderate efficacy and remarkable safety along with examining the data from various studies. How to cite this article Malhotra N, Garg R, Malhotra N, Malhotra J. Oral Allylestrenol: A Pregnancy-supporting Progestogen. J South Asian Feder Obst Gynae 2017;9(4):297-303.

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Nonsteroidal anti-inflammatory drugs: certain aspects of the use in obstetric clinic

HEALTH OF WOMAN ◽

10.15574/hw.2016.113.11 ◽

2016 ◽

pp. 11-15

Author(s):

L.H. Nazarenko ◽

Keyword(s):

Side Effects ◽

Premature Birth ◽

Preterm Labor ◽

Clinical Medicine ◽

Postoperative Pain Management ◽

Basic Component ◽

Threatened Preterm Labor ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

Obstetric Clinic

The article discusses the pathogenetic basis of a nonsteroidal anti-inflammatory drugs (NSAIDs) in clinical medicine. Presented classification and list registered in Ukraine representatives of this group of drugs. Posted current understanding of the mechanisms of clinical efficacy of NSAIDs and side effects. Presented the information about the place NSPVP during pregnancy, risks to the fetus, positive aspects in the management of women with threatened preterm labor, pathological preliminary period, as well as a basic component of postoperative pain management after obstetric and gynecological operations. Key words: nonsteroidal anti-inflammatory drug, premature birth, preliminary period, postoperative analgesia.

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Faculty Opinions recommendation of Preeclampsia, gestational hypertension and intrauterine growth restriction, related or independent conditions?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13695.471130 ◽

2006 ◽

Author(s):

Jeff Dicke

Keyword(s):

Intrauterine Growth Restriction ◽

Gestational Hypertension ◽

Growth Restriction ◽

Intrauterine Growth

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Optimization of Imminent Labor Prediction Systems in Women with Threatened Preterm Labor Based on Electrohysterography

Sensors ◽

10.3390/s21072496 ◽

2021 ◽

Vol 21 (7) ◽

pp. 2496

Author(s):

Gema Prats-Boluda ◽

Julio Pastor-Tronch ◽

Javier Garcia-Casado ◽

Rogelio Monfort-Ortíz ◽

Alfredo Perales Marín ◽

...

Keyword(s):

Preterm Labor ◽

Cervical Length ◽

Validation Dataset ◽

Computationally Efficient ◽

K Nearest Neighbors ◽

Predictive Values ◽

Classifier Design ◽

Input Dataset ◽

Threatened Preterm Labor ◽

Learning Machine

Preterm birth is the leading cause of death in newborns and the survivors are prone to health complications. Threatened preterm labor (TPL) is the most common cause of hospitalization in the second half of pregnancy. The current methods used in clinical practice to diagnose preterm labor, the Bishop score or cervical length, have high negative predictive values but not positive ones. In this work we analyzed the performance of computationally efficient classification algorithms, based on electrohysterographic recordings (EHG), such as random forest (RF), extreme learning machine (ELM) and K-nearest neighbors (KNN) for imminent labor (<7 days) prediction in women with TPL, using the 50th or 10th–90th percentiles of temporal, spectral and nonlinear EHG parameters with and without obstetric data inputs. Two criteria were assessed for the classifier design: F1-score and sensitivity. RFF1_2 and ELMF1_2 provided the highest F1-score values in the validation dataset, (88.17 ± 8.34% and 90.2 ± 4.43%) with the 50th percentile of EHG and obstetric inputs. ELMF1_2 outperformed RFF1_2 in sensitivity, being similar to those of ELMSens (sensitivity optimization). The 10th–90th percentiles did not provide a significant improvement over the 50th percentile. KNN performance was highly sensitive to the input dataset, with a high generalization capability.

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Impact of metformin treatment during pregnancy on maternal outcomes: a systematic review/meta-analysis

Scientific Reports ◽

10.1038/s41598-021-88650-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jane L. Tarry-Adkins ◽

Susan E. Ozanne ◽

Catherine E. Aiken

Keyword(s):

Side Effects ◽

Pregnancy Outcomes ◽

Gestational Hypertension ◽

Risk Of Bias ◽

Maternal Outcomes ◽

Metformin Treatment ◽

Eligibility Criteria ◽

Treatment Groups ◽

Gastrointestinal Side Effects ◽

The Impact

AbstractWe systematically assessed the impact of metformin treatment on maternal pregnancy outcomes. PubMed, Ovid Embase, Medline, Web of Science, ClinicalTrials.gov and Cochrane databases were systematically searched (inception-1st February 2021). Randomised controlled trials reporting pregnancy outcomes in women randomised to metformin versus any other treatment for any indication were included. Outcomes included gestational weight gain (GWG), pre-eclampsia, gestational hypertension, preterm birth, gestational age at delivery, caesarean section, gestational diabetes, glycaemic control, and gastrointestinal side-effects. Two independent reviewers conducted screening, with a third available to evaluate disagreements. Risk-of-bias and GRADE assessments were conducted using Cochrane Risk-of-Bias and GRADE-pro software. Thirty-five studies (n = 8033 pregnancies) met eligibility criteria. GWG was lower in pregnancies randomised to metformin versus other treatments (1.57 kg ± 0.60 kg; I2 = 86%, p < 0.0001), as was likelihood of pre-eclampsia (OR 0.69, 95% CI 0.50–0.95; I2 = 55%, p = 0.02). The risk of gastrointestinal side-effects was greater in metformin-exposed versus other treatment groups (OR 2.43, 95% CI 1.53–3.84; I2 = 76%, p = 0.0002). The risk of other maternal outcomes assessed was not significantly different between metformin-exposed versus other treatment groups. Metformin for any indication during pregnancy is associated with lower GWG and a modest reduced risk of pre-eclampsia, but increased gastrointestinal side-effects compared to other treatments.

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