RESUMO
OBJECTIVE: To evaluate whether maintenance treatment with vaginal progesterone after an arrested preterm labour reduces the incidence of preterm delivery. DESIGN: Multicentre, randomised, double-blind, placebo-controlled trial. SETTING: Twelve tertiary care centres in Spain. POPULATION: A total of 265 women with singleton pregnancy, preterm labour successfully arrested with tocolytic treatment, and cervical length of <25 mm. METHODS: Randomisation was stratified by gestational age (from 24.0 to <31.0 weeks of gestation and from 31.0 to <34.0 weeks of gestation) and centre. Patients were randomly assigned, in a 1 : 1 ratio, to either daily vaginal capsules of 200 mg progesterone or placebo until delivery or 36.6 weeks of gestation, whichever occurred first. MAIN OUTCOME MEASURES: Primary outcome was delivery before 34.0 and 37.0 weeks of gestation. Secondary outcomes were discharge-to-delivery time, readmissions because of preterm labour, emergency service use, and neonatal morbidity and mortality. RESULTS: From June 2008 through June 2012, 1419 women were screened: 472 met the inclusion criteria and 265 were randomised. The final analysis included 258 women: 126 in the progesterone group and 132 in the placebo group. There were no significant differences between the progesterone and placebo groups in terms of delivery at <34 weeks of gestation [9/126 (7.1%) versus 10/132 (7.6%), P = 0.91] or <37 weeks of gestation [36/126 (28.6%) versus 29/132 (22.0%), P = 0.22]. There were no differences observed between groups when considering the two strata of gestational age at inclusion. CONCLUSIONS: A maintenance treatment of 200 mg of daily vaginal progesterone capsules in women discharged home after an episode of arrested preterm labour did not significantly reduce the rate of preterm delivery. TWEETABLE ABSTRACT: Maintenance progesterone in 258 women after arrested PTL showed no benefit.
Assuntos
Método Duplo-Cego , Progesterona/administração & dosagem , Feminino , Humanos , Recém-Nascido , Trabalho de Parto Prematuro/tratamento farmacológico , Nascimento Prematuro/tratamento farmacológico , VaginaRESUMO
No disponible
Assuntos
Adulto , Gravidez , Feminino , Masculino , Humanos , Recém-Nascido , Síndrome do Abdome em Ameixa Seca/diagnóstico , Síndrome do Abdome em Ameixa Seca , Viabilidade Fetal/fisiologia , Diagnóstico Pré-Natal/métodos , Ultrassonografia Pré-Natal/métodos , Complicações na Gravidez/diagnóstico , Complicações na Gravidez , Criptorquidismo/complicações , Criptorquidismo/diagnóstico , Cariótipo XYY/fisiopatologia , Mortalidade Infantil , Prognóstico , Prognóstico Clínico Dinâmico HomeopáticoRESUMO
No disponible
Assuntos
Adulto , Gravidez , Feminino , Humanos , Complicações na Gravidez/diagnóstico , Gravidez Ectópica/complicações , Gravidez Ectópica/diagnóstico , Gravidez Ectópica/etiologia , Diagnóstico Pré-Natal/métodos , Laparotomia/métodos , Salpingostomia/métodos , Gravidez Tubária/complicações , Gravidez Tubária/diagnóstico , Gravidez Tubária , Laparoscopia/métodos , Gravidez Ectópica/epidemiologia , Gravidez Ectópica/fisiopatologia , Histerossalpingografia/métodos , Salpingostomia/métodosRESUMO
No disponible
Assuntos
Adulto , Gravidez , Feminino , Humanos , Histeroscopia/métodos , Metrorragia/diagnóstico , Metrorragia/cirurgia , Pólipos/cirurgia , Pólipos/diagnóstico , Técnicas Histológicas , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/complicações , Hematoma/cirurgia , Hematoma/diagnóstico , Hematoma , Complicações na Gravidez/cirurgia , Complicações na Gravidez/diagnóstico , Descolamento Prematuro da Placenta/complicações , Descolamento Prematuro da Placenta/diagnóstico , Índice de Apgar , Primeiro Trimestre da Gravidez , Hematoma/etiologia , Hematoma/fisiopatologia , Hematoma/patologiaRESUMO
Pregnancy is related to an increased frequency of arrhythmias in asymptomatic patients with Wolff-Parkinson-White syndrome, which might lead to sudden death. A 40-year-old woman, with Wolff-Parkinson-White syndrome which was not diagnosed until pregnancy, presented in the 34th week with an atrial fibrillation, with high risk criteria for ventricular fibrillation. Intravenous ajmaline was given to convert the tachyarrhythmia to sinus rhythm. We obtained an excellent maternal control with no maternal or fetal adverse effects.
