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1.
BJOG ; 122(1): 80-91, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25209926

RESUMO

OBJECTIVE: To evaluate the effectiveness of 200 mg of daily vaginal natural progesterone to prevent preterm birth in women with preterm labour. DESIGN: Multicentre, randomised, double-blind, placebo-controlled trial. SETTING: Twenty-nine centres in Switzerland and Argentina. POPULATION: A total of 385 women with preterm labour (24(0/7) to 33(6/7) weeks of gestation) treated with acute tocolysis. METHODS: Participants were randomly allocated to either 200 mg daily of self-administered vaginal progesterone or placebo within 48 hours of starting acute tocolysis. MAIN OUTCOME MEASURES: Primary outcome was delivery before 37 weeks of gestation. Secondary outcomes were delivery before 32 and 34 weeks, adverse effects, duration of tocolysis, re-admissions for preterm labour, length of hospital stay, and neonatal morbidity and mortality. The study was ended prematurely based on results of the intermediate analysis. RESULTS: Preterm birth occurred in 42.5% of women in the progesterone group versus 35.5% in the placebo group (relative risk [RR] 1.2; 95% confidence interval [95% CI] 0.93-1.5). Delivery at <32 and <34 weeks did not differ between the two groups (12.9 versus 9.7%; [RR 1.3; 95% CI 0.7-2.5] and 19.7 versus 12.9% [RR 1.5; 95% CI 0.9-2.4], respectively). The duration of tocolysis, hospitalisation, and recurrence of preterm labour were comparable between groups. Neonatal morbidity occurred in 44 (22.8%) cases on progesterone versus 35 (18.8%) cases on placebo (RR: 1.2; 95% CI 0.82-1.8), whereas there were 4 (2%) neonatal deaths in each study group. CONCLUSION: There is no evidence that the daily administration of 200 mg vaginal progesterone decreases preterm birth or improves neonatal outcome in women with preterm labour.


Assuntos
Peso ao Nascer , Trabalho de Parto Prematuro/tratamento farmacológico , Nascimento Prematuro/prevenção & controle , Progesterona/uso terapêutico , Progestinas/uso terapêutico , Administração Intravaginal , Adulto , Índice de Apgar , Método Duplo-Cego , Feminino , Humanos , Indometacina/uso terapêutico , Lactente , Mortalidade Infantil , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Receptores de Ocitocina/antagonistas & inibidores , Tocolíticos/uso terapêutico , Adulto Jovem
2.
Genet. mol. res. (Online) ; 4(2): 143-151, 30 jun. 2005. tab, ilus
Artigo em Inglês | LILACS | ID: lil-445297

RESUMO

We studied chromosomal abnormalities in arrested embryos produced by assisted reproductive technology with fluorescence in situ hybridization (FISH) and comparative genomic hybridization (CGH) in order to determine the best technique for evaluating chromosomal aneusomies to be implemented in different situations. We examined individual blastomeres from arrested embryos by FISH and arrested whole embryos by CGH. All of the 10 FISH-analyzed embryos gave results, while only 7 of the 30 embryos analyzed by CGH were usable. Fifteen of the 17 embryos were chromosomally abnormal. CGH provided more accurate data for arrested embryos; however, FISH is the technique of choice for screening in preimplantation genetic diagnosis, because the results can be obtained within a day, while the embryos are still in culture.


Assuntos
Humanos , Feminino , Gravidez , Hibridização in Situ Fluorescente , Cariotipagem/métodos , Diagnóstico Pré-Implantação/métodos , Genômica , Transtornos Cromossômicos/diagnóstico , Transtornos Cromossômicos/embriologia , Transtornos Cromossômicos/genética , Técnicas de Reprodução Assistida
3.
J Sex Marital Ther ; 29 Suppl 1: 1-10, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12735085

RESUMO

There are limited hemodynamic data in women with arousal or orgasmic disorders and even fewer normative control hemodynamic data in women without sexual dysfunction. In addition, there is limited experience with topical vasoactive agents (used to maximize genital smooth muscle relaxation) applied to the external genitalia during hemodynamic evaluations. The aim of this study was to report duplex Doppler ultrasound clitoral cavernosal arterial changes before and after topical PGE-1 (Alprostadil) administration in control women and in patients with arousal and orgasmic sexual disorders. We found that women with sexual arousal and orgasmic disorders had significantly (p < 0.05) diminished clitoral peak systolic and end diastolic velocity responses compared to controls. Further research is needed to establish the diagnostic role of topical vasoactive agents in the hemodynamic evaluation of women with sexual dysfunction.


Assuntos
Alprostadil/farmacologia , Clitóris , Disfunções Sexuais Psicogênicas/diagnóstico por imagem , Disfunções Sexuais Psicogênicas/tratamento farmacológico , Ultrassonografia Doppler Dupla , Vasodilatadores/farmacologia , Vasodilatadores/uso terapêutico , Administração Tópica , Adulto , Alprostadil/administração & dosagem , Clitóris/irrigação sanguínea , Clitóris/diagnóstico por imagem , Clitóris/efeitos dos fármacos , Feminino , Hemodinâmica/fisiologia , Humanos , Vasodilatadores/administração & dosagem
4.
Reprod Biomed Online ; 6(1): 66-8, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12626145

RESUMO

This paper reports the birth of a healthy baby resulting from transfer of blastocysts that were cryopreserved using propanediol after spontaneous hatching. A young infertile couple underwent IVF treatment in the clinic. After several IVF attempts, two births resulted; the first one with fresh embryos in 1996 after three IVF cycles, and the second one in 1999 (after a new IVF cycle in 1998) with frozen blastocysts that had remained cryopreserved in 1.5 mol/l propanediol and 0.1 mol/l sucrose after spontaneous hatching. This report of a healthy baby following transfer of hatched blastocysts frozen in propanediol supports further exploration of this approach.


Assuntos
Blastocisto/metabolismo , Criopreservação , Transferência Embrionária , Propilenoglicóis/metabolismo , Adulto , Feminino , Humanos , Gravidez
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