Is there enough evidence to support the use of 17 Alpha-Hydroxyprogesterone Caproate in preventing preterm labor in healthy women who have had a prior preterm delivery?

10.5580/3fe ◽  
2010 ◽  
Vol 7 (2) ◽  
Keyword(s):  
Preterm Delivery ◽  
Preterm Labor ◽  
Healthy Women ◽  
Hydroxyprogesterone Caproate

Prevention of preterm delivery after successful tocolysis in preterm labor by 17 alpha-hydroxyprogesterone caproate: A randomized controlled trial

2012 ◽  
Vol 206 (3) ◽  
pp. 206.e1-206.e9 ◽  
Author(s):  
Patrick Rozenberg ◽  
Aurelia Chauveaud ◽  
Philippe Deruelle ◽  
Marianne Capelle ◽  
Norbert Winer ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Preterm Delivery ◽  
Preterm Labor ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Hydroxyprogesterone Caproate

Association between Number of Prior Cesareans and Early Preterm Delivery in Women with Abnormal Placentation

2020 ◽  
Author(s):  
Ayamo Oben ◽  
Elizabeth B. Ausbeck ◽  
Melissa N. Gazi ◽  
Akila Subramaniam ◽  
Lorie M. Harper ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Preterm Labor ◽  
Placenta Previa ◽  
Secondary Analysis ◽  
Blood Products ◽  
Primary Analysis ◽  
Logistic Regression Models ◽  
Placenta Accreta Spectrum ◽  
Nicu Admission ◽  
Early Preterm Birth

Objective Delivery timing at 34 to 36 weeks is nationally recommended for pregnancies complicated by placenta accreta spectrum (PAS). However, it has recently been suggested that those with ≥2 prior cesarean deliveries (CD) and PAS should be delivered earlier than 34 weeks because of a higher risk of unscheduled delivery and complications. We sought to evaluate whether the number of prior CD in women with PAS is associated with early preterm delivery (PTD) (<34 weeks). We also evaluated the same relationship in women with placenta previa alone (without PAS). Study Design This is a secondary analysis of a multicenter and observational study that included women with prior CD (maternal–fetal medicine unit cesarean registry). Women with a diagnosis of PAS (regardless of placenta previa) were included for our primary analysis, and women with known placenta previa (without a component of PAS) were independently analyzed in a second analysis. Two groups of patients from the registry were studied: patients with PAS (regardless of placenta previa) and patients with placenta previa without PAS. The exposure of interest was the number of prior CD: ≥2 CD compared with <2 CD. The primary outcome was PTD <34 weeks. Secondary outcomes included preterm labor requiring hospitalization or tocolysis, transfusion of blood products, composites of maternal and neonatal morbidities, and NICU admission. Outcomes by prior CD number groups were compared in both cohorts. Backward selection was used to identify parsimonious logistic regression models. Results There were 194 women with PAS, 97 (50%) of whom had <2 prior CD and 97 (50%) of whom had ≥2 prior CD. The rate of PTD <34 weeks in women with ≥2 prior CD compared with <2 in the setting of PAS was 23.7 versus 29.9%, p = 0.27; preterm labor requiring hospitalization was 24.7 versus 13.5%; p = 0.05. The rates of plasma transfusion were increased with ≥2 prior CD (29.9 vs. 17.5%, p = 0.04), but there were no differences in transfusion of other products or in composite maternal or neonatal morbidities. After multivariable adjustments, having ≥2 CDs was not associated with PTD <34 weeks in women with PAS (adjusted odds ratio (aOR): 0.73, 95% confidence interval [CI]: 0.39–13.8) despite an association with preterm labor requiring hospitalization (aOR: 2.69; 95% CI: 1.15–6.32). In our second analysis, there were 687 women with placenta previa, 633 (92%) with <2 prior CD, and 54 (8%) with ≥2 prior CD. The rate of PTD <34 weeks with ≥2 CD in the setting of placenta previa was not significantly increased (27.8 vs. 22.1%, aOR: 1.49; 95% CI: 0.77–2.90, p = 0.08); the maternal composite outcome (aOR: 4.85; 95% CI: 2.43–9.67) and transfusion of blood products (aOR: 6.41; 95% CI: 2.30–17.82) were noted to be higher in the group with ≥2 prior CD. Conclusion Women with PAS who have had ≥2 prior CD as compared with women with <2 prior CD did not appear to have a higher risk of complications leading to delivery prior to 34 weeks. As such, considering the associated morbidity with early preterm birth, we would not recommend scheduled delivery prior to 34 weeks in this population. Key Points

146: Prediction of spontaneous preterm delivery in women with preterm labor: analysis of multiple proteins in maternal serum

2012 ◽  
Vol 206 (1) ◽  
pp. S77
Author(s):  
Panagiotis Tsiartas ◽  
Rose-Marie Holst ◽  
Ulla-Britt Wennerholm ◽  
Henrik Hagberg ◽  
David Hougaard ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Preterm Labor ◽  
Maternal Serum ◽  
Spontaneous Preterm Delivery

Can a 15-mm Cervical Length Cutoff Discriminate between Low and High Risk of Preterm Delivery in Women with Threatened Preterm Labor?

2011 ◽  
Vol 29 (3) ◽  
pp. 216-223 ◽  
Author(s):  
Camilla B. Wulff ◽  
Charlotte K. Ekelund ◽  
Morten Hedegaard ◽  
Ann Tabor
Keyword(s):  
High Risk ◽  
Preterm Delivery ◽  
Preterm Labor ◽  
Cervical Length ◽  
Threatened Preterm Labor

Anesthesia-Related Factors Associated with Preterm Labor and Delivery after Open Fetal Surgery

2020 ◽  
pp. 1-8
Author(s):  
Titilopemi A.O. Aina ◽  
Huirong Zhu ◽  
Jonathan Kim ◽  
Kobby A. Wiafe ◽  
Ahmed A. Nassr ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Preterm Labor ◽  
Diastolic Pressure ◽  
Anesthetic Management ◽  
Fetal Surgery ◽  
In Utero ◽  
Labor And Delivery ◽  
Maternal Complications ◽  
Related Factors ◽  
Increased Risk

<b><i>Background:</i></b> Fetal surgery, such as for meningomyelocele repair, has a clear clinical fetal benefit. In patients who undergo in utero repair of meningomyelocele, for example, there is reduced long-term disease morbidity. However, despite the beneficial effects of early intervention, women who undergo fetal interventions have an increased risk of preterm labor and delivery. Several surgery-related factors have been described but no specific anesthesia-related factors. <b><i>Objective:</i></b> The aim of this study was to determine if any aspects of the perioperative anesthetic management influenced maternal complications following in utero surgery. <b><i>Methods:</i></b> This was a retrospective chart review of the anesthetic management of mothers and fetuses who presented for open and fetoscopic myelomeningocele repair, between 2011 and 2015, at Texas Children’s Fetal Center®. <b><i>Results:</i></b> Forty-six women underwent open or fetoscopic repair of neural tube defects at our institution. We found the maternal heart rate in the postoperative period to be associated with a higher likelihood of preterm labor, but not delivery. The odds of having preterm delivery was higher for nulliparous patients and those with lower intraoperative diastolic pressure. <b><i>Conclusions:</i></b> Our findings confirm what has been previously reported regarding the association of nulliparity with preterm delivery. Additionally, this study highlights the importance of maintaining stable perioperative hemodynamics during the intraoperative and postoperative phases of care for patients undergoing in utero surgery.

scholarly journals Raoultella Bacteremia Presenting as an Acute Self-Limited Illness in an Obstetric Patient

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Justin Choi ◽  
Iqra Sheikh ◽  
Melissa Carr ◽  
Robert Shapiro ◽  
Karen Fluet
Keyword(s):  
Abdominal Pain ◽  
Caesarean Section ◽  
Preterm Delivery ◽  
Symptom Onset ◽  
Preterm Labor ◽  
Gravid Female ◽  
Breech Presentation ◽  
Male Infant ◽  
Blood Cultures ◽  
First Case

A 20 year-old female at 27-week gestation was admitted for threatened preterm delivery. Following an initially unremarkable hospital course for 12 days, the patient developed fever, chills, generalized malaise, abdominal pain, and diffuse myalgias on day 13 of hospitalization. Raoultella species was isolated from blood cultures on day 16 of hospitalization. The patient’s condition improved within 24 hours of symptom onset, prior to antibiotic initiation, and a premature, viable male infant at 29 weeks and 6 days of gestation was delivered via caesarean section four days later due to breech presentation in the setting of preterm labor. Here, we present the first case of a Raoultella species infection in a gravid female reported in the literature.

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