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【medical-news】孕激素可预防短宫颈妇女早产
Progesterone and the Risk of Preterm Birth among Women with a Short Cervix
Background Previous randomized trials have shown that progesterone administration in women who previously delivered prematurely reduces the risk of recurrent premature delivery. Asymptomatic women found at midgestation to have a short cervix are at greatly increased risk for spontaneous early preterm delivery, and it is unknown whether progesterone reduces this risk in such women.
Methods Cervical length was measured by transvaginal ultrasonography at a median of 22 weeks of gestation (range, 20 to 25) in 24,620 pregnant women seen for routine prenatal care. Cervical length was 15 mm or less in 413 of the women (1.7%), and 250 (60.5%) of these 413 women were randomly assigned to receive vaginal progesterone (200 mg each night) or placebo from 24 to 34 weeks of gestation. The primary outcome was spontaneous delivery before 34 weeks.
Results Spontaneous delivery before 34 weeks of gestation was less frequent in the progesterone group than in the placebo group (19.2% vs. 34.4%; relative risk, 0.56; 95% confidence interval [CI], 0.36 to 0.86). Progesterone was associated with a nonsignificant reduction in neonatal morbidity (8.1% vs. 13.8%; relative risk, 0.59; 95% CI, 0.26 to 1.25; P=0.17). There were no serious adverse events associated with the use of progesterone.
Conclusions In women with a short cervix, treatment with progesterone reduces the rate of spontaneous early preterm delivery. Progesterone and the Risk of Preterm Birth among Women with a Short Cervix
孕激素与短宫颈孕妇的早产风险
Background Previous randomized trials have shown that progesterone administration in women who previously delivered prematurely reduces the risk of recurrent premature delivery. Asymptomatic women found at midgestation to have a short cervix are at greatly increased risk for spontaneous early preterm delivery, and it is unknown whether progesterone reduces this risk in such women.
背景
先前已经有随机试验证实有早产史的孕妇使用孕激素可以降低现在早产的风险。直到孕中期才发现的无症状的短宫颈的孕妇其自然早产的风险是大大增加的，，而且究竟孕激素能否减少该种风险还不得而知。
Methods Cervical length was measured by transvaginal ultrasonography at a median of 22 weeks of gestation (range, 20 to 25) in 24,620 pregnant women seen for routine prenatal care. Cervical length was 15 mm or less in 413 of the women (1.7%), and 250 (60.5%) of these 413 women were randomly assigned to receive vaginal progesterone (200 mg each night) or placebo from 24 to 34 weeks of gestation. The primary outcome was spontaneous delivery before 34 weeks.
方法
通过经阴道B超检查24620名常规产前保健的孕妇的宫颈长度，她们的平均孕周是22周（20～25周）。宫颈长度在15mm及以下的有413名，其中的250名被随机分配至两组，一组接受经阴道的孕激素（200mg每晚），另一组接受安慰剂，疗程均是从孕24周至34周。主要指标是34周之前的自发流产。
Results Spontaneous delivery before 34 weeks of gestation was less frequent in the progesterone group than in the placebo group (19.2% vs. 34.4%; relative risk, 0.56; 95% confidence interval [CI], 0.36 to 0.86). Progesterone was associated with a nonsignificant reduction in neonatal morbidity (8.1% vs. 13.8%; relative risk, 0.59; 95% CI, 0.26 to 1.25; P=0.17). There were no serious adverse events associated with the use of progesterone.
结果
孕激素组在孕34周以前的自然流产的几率小于安慰剂组 (19.2% vs. 34.4%; relative risk, 0.56; 95% confidence interval [CI], 0.36 to 0.86)，孕激素还能减少新生儿死亡率，虽然减少程度不明显(8.1% vs. 13.8%; relative risk, 0.59; 95% CI, 0.26 to 1.25; P=0.17)；孕激素使用后也未见严重的不良反应。
Conclusions In women with a short cervix, treatment with progesterone reduces the rate of spontaneous early preterm delivery.
结论
在短宫颈的妇女，孕激素治疗可以减少自发早产的机率。 编译
孕激素可预防短宫颈妇女早产
据8月2日《新英格兰医学杂志》报道，来自伦敦国王学院医院的Eduardo B. Fonseca等研究者证实了孕激素治疗可以减少短宫颈妇女自发早产的机率，而且使用后也未见严重的不良反应。
先前已经有随机试验证实有早产史的孕妇使用孕激素可以降低现在早产的风险。直到孕中期才发现的无症状的短宫颈的孕妇其自然早产的风险是大大增加的，而且究竟孕激素能否减少该种风险还不得而知。在该试验中，研究者们先是通过经阴道B超检查了24620名平均孕周为22周（20～25周）的常规产前保健的孕妇的宫颈长度，发现宫颈长度在15mm及以下的有413名，他们将这其中的250名孕妇随机分配至两组，一组接受经阴道的孕激素治疗（200mg每晚），另一组接受安慰剂，疗程均是从孕24周至34周。主要观察指标是34周之前的自发流产。结果发现，孕激素组在孕34周以前的自然流产的几率和新生儿死亡率均小于安慰剂组 ，虽然后者减少程度不明显；而且孕激素使用后也未见严重的不良反应。因此他们得出结论，孕激素治疗可以减少短宫颈妇女早产的机率。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-03-06 05:24
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