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Ritodrine in Oral Maintenance of Tocolysis after Active Preterm Labor: Randomized Controlled Trial

Matijević, Ratko; Grgić, Ozren; Vasilj, Oliver
Fonte: Croatian Medical Schools Publicador: Croatian Medical Schools
Tipo: Artigo de Revista Científica
Publicado em /02/2006 EN
Relevância na Pesquisa
16.19%

Role of Aldo–Keto Reductase Enzymes in Mediating the Timing of Parturition

Byrns, Michael C.
Fonte: Frontiers Research Foundation Publicador: Frontiers Research Foundation
Tipo: Artigo de Revista Científica
Publicado em 09/01/2012 EN
Relevância na Pesquisa
16.19%
A better understanding of the mechanisms underlying parturition would provide an important step toward improving therapies for the prevention of preterm labor. Aldo–keto reductases (AKR) from the 1D, 1C, and 1B subfamilies likely contribute to determining the timing of parturition through metabolism of progesterone and prostaglandins. Placental AKR1D1 (human 5β reductase) likely contributes to the maintenance of pregnancy through the formation of 5β-dihydroprogesterone (DHP). AKR1C1, AKR1C2, and AKR1C3 catalyze the 20-ketosteroid and 3-ketosteroid reduction of progestins. They could therefore eliminate tocolytic progestins at term. Activation of the F prostanoid receptor by its ligands also plays a critical role in initiation of labor. AKR1C3 and AKR1B1 have prostaglandin (PG) F synthase activities that likely contribute to the initiation of labor. AKR1C3 converts PGH2 to PGF2α and PGD2 to 9α,11β-PGF2. AKR1B1 also reduces PGH2 to PGF2α, but does not form 9α,11β-PGF2. Consistent with the potential role for AKR1C3 in the initiation of parturition, indomethacin, which is a potent and isoform selective inhibitor of AKR1C3, has long been used for tocolysis.

Individual and Organisational Determinants Associated with Maintenance Tocolysis in the Management of Preterm Labour: A Multilevel Analysis

Diguisto, Caroline; Le Ray, Camille; Maillard, Françoise; Khoshnood, Babak; Verspyck, Eric; Perrotin, Franck; Goffinet, François;
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Publicado em 13/12/2012 EN
Relevância na Pesquisa
26.19%

The Evidence Regarding Maintenance Tocolysis

Elliott, John P.; Morrison, John C.
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.4%
Preterm delivery is a public health issue of major proportion. More than 12% of deliveries in the United States that occur at less than 37 weeks gestation preterm labor (PTL) represents the largest single reason for preterm birth (PTB). Attempts to prevent PTB have been unsuccessful. This paper of maintenance tocolytic therapy will examine the efficacy and safety of the drugs, both oral and subcutaneous, which have been utilized for prolongation of pregnancy following successful arrest of a documented episode of acute preterm labor. The evidence for oral tocolytics as maintenance therapy as well as parenteral medications for such patients is offered. Finally, the effects in the United States of the Food and Drug Administration (FDA) action on such medications are reported.

Subcutaneous Terbutaline Pump for Maintenance of Tocolysis following Arrest of Acute Preterm Labor

Singh, Kavita; Ansari, Mohammed T.; Gaudet, Laura M.
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
16.19%

Effect of maintenance tocolysis with nifedipine in threatened preterm labor on perinatal outcomes: a randomized controlled trial

Roos, C.; Spaanderman, M.; Schuit, E.; Bloemenkamp, K.; Bolte, A.; Cornette, J.; Duvekot, J.; van Eyck, J.; Franssen, M.; de Groot, C.; Kok, J.; Kwee, A.; Merien, A.; Bijivank, B.; Opmeer, B.; Oudijk, M.; van Pampus, M.; Papatsonis, D.; Porath, M.; Scheep
Fonte: American Medical Association Publicador: American Medical Association
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
47.26%
IMPORTANCE In threatened preterm labor, maintenance tocolysis with nifedipine, after an initial course of tocolysis and corticosteroids for 48 hours, may improve perinatal outcome. OBJECTIVE To determine whether maintenance tocolysis with nifedipine will reduce adverse perinatal outcomes due to premature birth. DESIGN, SETTING, AND PARTICIPANTS APOSTEL-II (Assessment of Perinatal Outcome with Sustained Tocolysis in Early Labor) is a double-blind, placebo-controlled trial performed in 11 perinatal units including all tertiary centers in the Netherlands. From June 2008 to February 2010, women with threatened preterm labor between 26 weeks (plus 0 days) and 32 weeks (plus 2 days) gestation, who had not delivered after 48 hours of tocolysis and a completed course of corticosteroids, were enrolled. Surviving infants were followed up until 6 months after birth (ended August 2010). INTERVENTION Randomization assigned 406 women to maintenance tocolysis with nifedipine orally (80 mg/d; n = 201) or placebo (n = 205) for 12 days. Assigned treatment was masked from investigators, participants, clinicians, and research nurses. MAIN OUTCOME MEASURES Primary outcome was a composite of adverse perinatal outcomes (perinatal death, chronic lung disease...

The NIFTY study: a multi-centre randomised double blind placebo controlled trial of nifedipine maintenance tocolysis in fetal fibronectin positive women in threatened preterm labour

Parry, E.; Roos, C.; Stone, P.; Hayward, L.; Mol, B.W.; McCowan, L.
Fonte: Mosby Publicador: Mosby
Tipo: Conference item
Publicado em //2012 EN
Relevância na Pesquisa
26.19%
Emma Parry, Carolien Roos, Peter Stone, Lynsey Hayward, Ben Willem Mol, Lesley McCowan; Poster abstract 473

Projesterone in preterm birth: role of regulatory T-cells; Progesterona no parto pré-termo: papel das células T reguladoras

Areia, Ana Luísa Fialho Amaral de
Fonte: Universidade de Coimbra Publicador: Universidade de Coimbra
Tipo: Tese de Doutorado
ENG
Relevância na Pesquisa
16.19%
O Parto pré-termo (PTL) é uma das principais causas de morbilidade e mortalidade neonatais, sendo responsável por 11% de todos os partos, ocorrendo espontaneamente na maioria dos casos. Mesmo as crianças que sobrevivem a um PTL têm maior incidência de sequelas a longo prazo, abrangendo défices de desenvolvimento psico-motor, patologia neurológica (como a paralisia cerebral) e um aumento do risco de doenças da vida adulta. As mulheres com ameaça de parto pré-termo revertida com tocólise, mantêm um risco elevado de episódios recorrentes. A terapia tocolítica de manutenção é ainda controversa mas o uso de progesterona nestes casos, tem-se revelado promissora. No entanto, a sua utilização não está ainda bem protocolada, para o que contribui a ausência de explicação científica clara para o seu modo de atuação. Assim, na gestação, a progesterona atua como um imuno-esteróide, contribuindo para o estabelecimento de um meio protetor. Durante a gravidez, a função primordial das células T reguladoras (Treg) circulantes parece ser a proteção da unidade feto-trofoblástica da rejeição pelo sistema imunológico materno, sob a influência da progesterona. As células Treg medeiam a sua função protetora através do contacto célula a célula ou pela secreção de citocinas imunossupressoras. Vários estudos demonstraram que a supressão da função dos leucócitos ativados pelas células Treg é obtida através da produção de IL-10 e TGF-β. Por outro lado...

Impact of a randomized trial on maintenance tocolysis on length of hospital admission of women with threatened preterm labor in the Netherlands

Lange, T.S.D.; Roos, C.; Bloemenkamp, K.W.M.; Bolte, A.C.; Duvekot, J.J.J.; Franssen, M.T.M.; Kok, M.; Oudijk, M.A.; Porath, M.M.; Post, J.A.M.V.D.; Mol, B.W.J.
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
Relevância na Pesquisa
46.64%
Abstract not available.; Thomas S. de Lange, Carolien Roos b, Kitty W.M. Bloemenkamp, Antoinette C. Bolte, Johannes J.J. Duvekot, Maureen T.M. Franssen, Marjolein Kok, Martijn A. Oudijk, Martina M. Porath, Joris A.M. van der Post, Ben Willem J. Mol

Magnesium maintenance therapy for preventing preterm birth after threatened preterm labour (Review)

Han, S.; Crowther, C.; Moore, V.
Fonte: Update Software Ltd Publicador: Update Software Ltd
Tipo: Artigo de Revista Científica
Publicado em //1998 EN
Relevância na Pesquisa
36.47%
BACKGROUND: Magnesium maintenance therapy is one of the types of tocolytic therapy used after an episode of threatened preterm labour (usually treated with an initial dose of tocolytic therapy) in an attempt to prevent the onset of further preterm contractions. OBJECTIVES: To assess whether magnesium maintenance therapy is effective in preventing preterm birth after the initial threatened preterm labour is arrested. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (May 2010). SELECTION CRITERIA: Randomised controlled trials of magnesium therapy given to women after threatened preterm labour. DATA COLLECTION AND ANALYSIS: The review authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. We checked data entry. MAIN RESULTS: We included four trials, which recruited 422 women. Three trials had high risk of bias and none included any long-term follow up of infants. No differences in the incidence of preterm birth or perinatal mortality were seen when magnesium maintenance therapy was compared with placebo or no treatment; or alternative therapies (ritodrine or terbutaline). The risk ratio (RR) for preterm birth (less than 37 weeks) for magnesium compared with placebo or no treatment was 1.05...

Magnesium for preventing preterm birth after threatened preterm labour

Crowther, C.; Moore, V.
Fonte: Update Software Ltd Publicador: Update Software Ltd
Tipo: Artigo de Revista Científica
Publicado em //2000 EN
Relevância na Pesquisa
26.4%
BACKGROUND: Magnesium therapy is sometimes continued after an episode of threatened preterm labour in an attempt to prevent the onset of further preterm contractions. OBJECTIVES: The objective of this review was to assess the effects of magnesium maintenance therapy on preventing preterm birth after threatened preterm labour. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register. SELECTION CRITERIA: Randomised controlled trials of magnesium therapy given to women after threatened preterm labour. DATA COLLECTION AND ANALYSIS: Trial quality assessment and data extraction were done independently by two reviewers. MAIN RESULTS: Two trials were included. Both were of poor quality and neither study included any long-term follow up of infants. The incidence of preterm birth or perinatal mortality was not reduced by magnesium maintenance therapy compared to alternative therapy or no treatment. REVIEWER'S CONCLUSIONS: There is not enough evidence to show that magnesium maintenance therapy is effective in preventing preterm birth after an episode of threatened preterm labour.

Pharmacokinetics of nifedipine slow-release during sustained tocolysis

ter Laak, M.A.; Roos, C.; Touw, D.J.; van Hattum, P.R.; Kwee, A.; Lotgering, F.K.; Mol, B.W.; van Pampus, M.G.; Porath, M.M.; Spaanderman, M.E.; van der Post, J.A.; Papatsonis, D.N.; van 't Veer, N.E.
Fonte: Dustri-Verlag Publicador: Dustri-Verlag
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
Relevância na Pesquisa
36.67%
OBJECTIVE: The pharmacokinetics of nifedipine as a tocolytic agent has not been studied in great detail in pregnant women and has instead focused on immediate release tablets and gastrointestinal therapeutic system (GITS) tablets. The aim of this study was to determine nifedipine slow-release half-life and distribution volume in pregnant women and to compare these with pharmacokinetic parameters of nifedipine in non-pregnant subjects described in the literature. MATERIALS: This is a study parallel to a trial studying women with threatened preterm labor between 26 + 0 and 32 + 2 weeks after initial tocolysis and a completed course of corticosteroids, who were randomly allocated to maintenance nifedipine (slow-release tablets 20 mg 4 times daily) or placebo. Exclusion criteria for the pharmacokinetic study were contra-indications for nifedipine, impaired liver function, and concomitant intake of inhibitors or inducers of the cytochrome P450 3A4 isoenzyme. Blood samples for measuring nifedipine plasma concentrations were drawn at t = 0, t = 12 hours, t = 24 hours, t = 48 hours, t = 72 hours, t = 7 days, and t = 9 days. METHODS: Pharmacokinetic parameters were estimated using iterative two-stage Bayesian population pharmacokinetic analysis by MWPharm© software. The study was designed to establish a correlation between body weight and nifedipine plasma level. RESULTS: The pharmacokinetic parameters of nifedipine slow-release tablets were determined from the data of 8 pregnant women. Nifedipine slow-release had a half-life of 2 - 5 hours...

Magnesium maintenance therapy for preventing preterm birth after threatened preterm labour

Han, S.; Crowther, C.; Moore, V.
Fonte: Update Software Ltd Publicador: Update Software Ltd
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
36.47%
BACKGROUND Magnesium maintenance therapy is one of the types of tocolytic therapy used after an episode of threatened preterm labour (usually treated with an initial dose of tocolytic therapy) in an attempt to prevent the onset of further preterm contractions. OBJECTIVES To assess whether magnesium maintenance therapy is effective in preventing preterm birth after the initial threatened preterm labour is arrested. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2013). SELECTION CRITERIA Randomised controlled trials of magnesium therapy given to women after threatened preterm labour. DATA COLLECTION AND ANALYSIS The review authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. We checked data entry. MAIN RESULTS We included four trials involving 422 women. Three trials had high risk of bias and none included any long-term follow-up of infants. No differences in the incidence of preterm birth or perinatal mortality were seen when magnesium maintenance therapy was compared with placebo or no treatment; or alternative therapies (ritodrine or terbutaline). The risk ratio (RR) for preterm birth (less than 37 weeks) for magnesium compared with placebo or no treatment was 1.05...

The NIFTY study: a multicentre randomised double-blind placebo-controlled trial of nifedipine maintenance tocolysis in fetal fibronectin-positive women in threatened preterm labour

Parry, E.; Roos, C.; Stone, P.; Hayward, L.; Mol, B.W.; McCowen, L.
Fonte: Wiley Publicador: Wiley
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
Relevância na Pesquisa
67.12%
OBJECTIVE: In an unselected group of women with signs of preterm labour, maintenance tocolysis is not effective in the prevention of preterm birth and does not improve neonatal outcome. Among women with signs of preterm labour, those who are fetal fibronectin positive have an increased risk of preterm birth. We investigated whether maintenance tocolysis with nifedipine would delay delivery and improve neonatal outcome in women with threatened preterm labour and a positive fetal fibronectin status. STUDY DESIGN: Women with a singleton pregnancy in threatened preterm labour (24(+0) to 33(+6)  weeks) with a positive fetal fibronectin test were randomised to nifedipine or placebo. Study medication was continued until 36 completed weeks' gestation. The primary endpoint was prolongation of pregnancy of seven days. Secondary endpoints were gestational age at delivery and length of NICU admission. RESULTS: Of the 60 participants, 29 received nifedipine and 31 placebo. Prolongation of pregnancy by >7 days occurred in 22/29 (76%) in the nifedipine group and 25/31 (81%) in the placebo group (relative risks, RR 0.94 [0.72-1.2]). Gestational age at delivery was 36.1 ± 5.1 weeks for nifedipine and 36.8 ± 3.6 weeks for placebo (P = 0.027). Length of NICU admission [median (interquartile ranges...