Pregnant Women Diagnosed with Threatened Preterm Labor What They Experience in the Hospital?: A Qualitative Study

Objective: The effectiveness of progesterone in the prevention of threatened preterm labor has been established for many years, but the preferable route, dose, and duration of treatment are until now under the evaluation of researches. The aim of this study was to determine the effect of rectal progesterone on Doppler indices of the uterine arteries in pregnant women with threatened preterm delivery.Methods: A prospective case–control study was conducted at the obstetric ward and the Outpatients Department of Al-Yarmouk Teaching Hospital in Baghdad for the period of 1 year from April 1, 2017, to April 1, 2018. 100 women were enrolled in the study, 50 of them were pregnant women with a diagnosis of preterm labor assigned as a study group and the other 50 were apparently healthy pregnant women of the same gestational age assigned as a control group. Doppler study of uterine arteries was done to all participants, and the results were compared for both groups. The patients with preterm labor received nifedipine tocolysis initially until contractions subsided and Doppler study had been repeated for those women after 1 week of rectal progesterone therapy.Results: The study group had a significantly higher resistance index (RI) than the control group (0.58 vs. 0.52) as p<0.05, in spite of the pulsatility index (PI) being higher for the study group compared to the control group (0.78 vs. 0.77) but this difference was not statistically significant. The RI before the therapy (0.58) was significantly higher than the index after therapy (0.52), and the PI was again significantly higher before therapy (0.78) than after therapy (0.71) as p<0.05. During the follow-up period, 3 (6.5%), 4 (8.7), and 39 (84.8%) patients delivered within 1 week, after 1 week, and at term, respectively.Conclusion: Rectal progesterone can arrest threatened preterm labor, and this effect is possible in part explained by its action on uterine arteries.

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Comparison of Nifedipine and Isoxsuprine to Cervical Length in Threatened Preterm Labor

Indonesian Journal of Obstetrics & Gynecology Science ◽

10.24198/obgynia/v4.n1.255 ◽

2021 ◽

Vol 4 (1) ◽

pp. 56-63

Author(s):

Triyoga Pramadana ◽

◽

Anita Rachmawati ◽

Dini Pusianawati

Keyword(s):

Pregnant Women ◽

General Hospital ◽

Preterm Labor ◽

Cervical Length ◽

P Value ◽

Inclusion Criteria ◽

Key Word ◽

Before And After ◽

Threatened Preterm Labor ◽

Length Changes

Objective: This study aimed to determine differences in cervical length changes between administration of nifedipine and isoxsuprine. Method: Subjects of the study were pregnant women who meet the inclusion criteria (n=16). Treatments were given for 48 hours. Parameters measured was the cervical length before and after the administration of nifedipine and isoxsuprine. This study was conducted in Dr. Hasan Sadikin General Hospital from January until April 2020. Result: Less shortening of the cervical length after administration of tocolytic isoxsuprin for 48 hours compared with tocolytic nifedipine and statistically significant with p value of 0.0001 (p<0.05) using Paired T tests. Conclusion: Isoxsuprin is more effective to prevent shortening of the cervical length compared to nifedipine in cases of threatened preterm labor. Key word: Nifedipine, Isoxsuprine, cervical length, threatened preterm labor

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Threatened Preterm Labor: Which are become Preterm Labor?

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v8i4.1299 ◽

2020 ◽

pp. 216-222

Author(s):

Cut M. Yeni ◽

Rismawati Tambunan ◽

Hasanuddin

Keyword(s):

Pregnant Women ◽

Preterm Labor ◽

Case Control ◽

Cervical Length ◽

Wilcoxon Test ◽

Fetal Fibronectin ◽

Whitney Test ◽

Vaginal Ph ◽

Chi Squared ◽

Threatened Preterm Labor

Objective: The research was aimed to show about characteristics of subject, fetal fibronectin, vaginal pH, cervical length of women with threatened preterm labor, and which are become preterm labor? Preterm labor is occurs most often in 20 weeks gestation to less than 37 weeks gestation. This condition is concerned about Obstetric problem and associated with significant neonatal morbidity and mortality.Methods: This study used the design of case control where preterm pregnant women who become research subjects divided into two groups with threat and without the threat of pre-term labor. Fetal fibronectin , vaginal pHand cervical length than in both groups were evaluated as a risk factor for preterm labor. Mann-Whitney test , Wilcoxon test and Chi-squared test were used as statistical tests with a confidence level of 95%.Results: A total of 86 preterm pregnant women involved in this study with an average age 30 , 5 ± 6.25 (group threat) 32.16 ± 5.25 (non-threatening). Comparison of fetal fibronectin (p = 0.005), vaginal PH(p <0.001) and length of the cervix (p <0.001) between the two groups showed a significant difference. A total of 8 subjects of the 43 in the group of pregnant women with the threat pretem labor experiencing preterm labor .Conclusion: The size of a short cervical length, an increase in the pH of the vaginal secretions and increased levels of fetal fibronectin is a clinical indicator for screening during pregnancy to assess the risk of a preterm labor .Keywords: cervical length, fetal fibronectin, pretermlabor , vaginal pH of the secretions. Abstrak Tujuan: Persalinan preterm adalah persalinan yang terjadi padausia kehamilan 20 hingga kurang dari37 minggu. Kondisi inimerupakanpermasalahan yang sangat mengkhawatirkan dalam bidang kebidanan dan dikaitkan dengan morbiditas dan kematian neonatal yang signifikan. Evaluasi dan skrining terhadap berbagai faktor resiko terjadinya ancaman persalinan preterm adalah hal terpenting dalam mencegah berbagai komplikasi yang mungkin timbul.Metode: Penelitian ini menggunakan desain case control dimana wanita hamil preterm yang menjadi subjek penelitian terbagi menjadi dua yakni kelompok dengan ancaman dan tanpa ancaman persalinan preterm. Fetal fibronectin, pH sekret vagina dan panjang serviks dibandingkan diatara kedua kelompok sebagai faktor resiko ancaman persalinan preterm. Mann-Whitney test, Wilcoxon test dan Chi – squared digunakan sebagai uji statistik dengan tingkat kepercayaan 95%.Hasil: Sebanyak 86 wanita hamil preterm terlibat dalam penelitian ini dengan rerata usia 30,5 ± 6,25 (kelompok ancaman) 32,16 ± 5,25 (tanpa ancaman). Perbandingan Fetal fibronectin (p=0,005), pH sekret vagina (p<0,001) dan panjang serviks (p<0,001) antar kedua kelompok menunjukkan adanya perbedaan yang bermakna. Sebanyak 8 subjek dari 43 pada kelompok wanita hamil pretem dengan ancaman persalinan preterm yang mengalami persalinan pretermKesimpulan:Ukuran panjang serviks yang pendek, peningkatan pH sekret vagina dan peningkatan kadar fetal fibronectin merupakan indikator klinis untuk skrining selama kehamilan guna menilai resiko terjadinya persalinan pretermKata kunci: fetal fibronectin, persalinan preterm, Ph vagina, panjang cerviks

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Prospects of the treatment of preterm labor by the use of sublingual forms of micronized progesterone

HEALTH OF WOMAN ◽

10.15574/hw.2016.113.28 ◽

2016 ◽

pp. 28-32

Author(s):

G.I. Reznichenko ◽

◽

N.Yu. Reznichenko ◽

V.Yu. Potebnya ◽

I.L. Antonyuk ◽

...

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

Preterm Labor ◽

Total Bilirubin ◽

Antenatal Clinic ◽

Premature Births ◽

Complex Treatment ◽

Delayed Treatment ◽

Threatened Preterm Labor ◽

Micronized Progesterone

The objective: to determine the efficacy of sublingual forms of micronized progesterone (Luteina) in treatment of women with preterm labor. Patients and methods. 45 women with preterm labor were examined in 24–35 weeks of gestation. 2 subgroups were formed. Subgroup Ia consisted of 23 women, who received micronized progesterone sublingually in complex treatment, subgroup IB consisted of 22 pregnant women, who didn’t receive progesterone. 56 case reports of premature births were analyzed retrospectively. The main group of pregnant women underwent general and biochemical examination, determination of ALT, AST, total bilirubin and progesterone. Results. Risk factors for preterm labor during observation in the antenatal clinic were established. They included the underestimation of anamnesis, incomplete examination, delayed treatment of threatened preterm labor, insufficient prevention of complications of pregnancy. It was established that the levels of both AST and ALT as well as total bilirubin in serum hadn’t change after the treatment in both subgroups of women from I group. The decrease in the serum level of progesterone was observed in both subgroups. Average concentration of progesterone in blood serum increased up to 1108±39 nmol/l on the third day of treatment in the subgroup Ia, and it reached 1260±42 nmol/l on the seventh day, whereas its dynamics practically didn’t chang in subgroup IB (882±33 nmol/l and 893±31 respectively). The use of sublingual form of micronized progesterone in the complex treatment of women with preterm labor gave the opportunity 2 times to decrease frequency of premature births, 1.5 times to decrease frequency of delivery complications, almost 2.5 to improve perinatal consequences compared to subgroup of women who hadn’t use progesterone. Conclusions. 1. Risk factors of preterm labor are delayed first prenatal visit of pregnant women to antenatal clinic, the underestimation of anamnesis and risk factors for the development of gestational complications, incomplete examination, delayed treatment of threatened preterm labor, incomplete prevention of pregnancy complications. 2. The use of sublingual forms of micronized progesterone in cases of signs of preterm labor permits to restore quickly the level of progesterone in blood serum to physiological parameters, 2 times to decrease the frequency of premature births and 2.5 times to decrease perinatal consequences in infants. 3. The use of sublingual form of micronized progesterone in pregnant women with preterm labor does not affect the function of the liver. 4. The obtained results allow to recommend the wide use of sublingval form of micronized progesterone to pregnant women with preterm labor. Key words: preterm labor, treatment, Luteina.

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