Prevention of spontaneous preterm birth: the role of sonographic cervical length in identifying patients who may benefit from progesterone treatment

@article{Romero2007PreventionOS,
  title={Prevention of spontaneous preterm birth: the role of sonographic cervical length in identifying patients who may benefit from progesterone treatment},
  author={Roberto J. Romero},
  journal={Ultrasound in Obstetrics and Gynecology},
  year={2007},
  volume={30}
}
  • R. Romero
  • Published 1 October 2007
  • Biology, Medicine
  • Ultrasound in Obstetrics and Gynecology
The importance of progesterone in the maintenance of mammalian pregnancy is well established1–18. Similarly, a decline in progesterone action is believed to be central to the initiation of parturition in most mammalian species, including primates5,7,8,12–14,19,20, although the precise mechanism for this in humans has not been elucidated5,7,9,13,14,21–25. Progestogen (a term that, like progestin, includes both ‘natural’ progesterone and synthetic compounds with progesterone action)26… 
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86 Citations
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86 Citations

Progesterone to prevent preterm birth in twin gestations: what is the next step forward?
  • R. Romero
  • Biology, Medicine
    BJOG : an international journal of obstetrics and gynaecology
  • 2013
TLDR
Progesterone is a key hormone for pregnancy maintenance, and a decline in progesterone action is considered to be central to the initiation of parturition in most mammalian species, including primates, so it is not surprising that many investigators have explored the use of progestersone for the prevention of preterm birth.
The effect of prenatal vaginal progesterone on cervical length in nonselected twin pregnancies
TLDR
Cervical shortening in asymptomatic nonselected twin pregnancies occurred at a similar rate, regardless of vaginal progesterone treatment, according to gestational age at birth.
Vaginal Progesterone to Reduce the Rate of Preterm Birth and Neonatal Morbidity: A Solution at Last
ISSN 1745-5057 Women's Health (2011) 7(5), 501–504 10.2217/WHE.11.60 shortand long-term complications. However, age alone does not tell us why the preterm birth occurred, and this has profound…
Progesterone to prevent spontaneous preterm birth.
Vaginal progesterone to prevent preterm birth in pregnant women with a sonographic short cervix: clinical and public health implications.
A blueprint for the prevention of preterm birth: vaginal progesterone in women with a short cervix
TLDR
Routine assessment of the risk of preterm birth with cervical ultrasound coupled with vaginal progesterone for women with a short cervix is cost-effective, and the implementation of such a policy is urgently needed.
Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and metaanalysis of individual patient data.
Management strategies for the prevention of preterm birth: part II – update on cervical cerclage
TLDR
Understanding that high-risk populations are not homogeneous and no single-approach modality is likely to be generally applicable, this work has combined the available evidence on both progesterone and cerclage to provide guidance on how to identify subgroups of women at significantly increased risk for PTB and how to preferentially consider progester one versus cerClage.
Vaginal progesterone after tocolytic therapy in threatened preterm labor
TLDR
The administration of vaginal progesterone after tocolysis in threatened preterm labor is associated with prolongation of pregnancy, and the reduction of deliveries before 34 weeks was observed in patients presenting with contractions after 27 weeks gestation.
Combined Low Dose Aspirin and 17 α Hydroxyl Progesterone versus 17 α Hydroxyl Progesterone Alone Study in Pregnancy: A Randomized Clinical Trial for Prevention of Spontaneous Preterm Birth
TLDR
Assessment of the efficacy of 17 alpha hydroxyl progesterone and low dose aspirin in reducing the rate of preterm birth in pregnant women at this risk found no significant difference between the groups.
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References

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