Effect of Progesterone on Latent Phase Prolongation in Patients With Preterm Premature Rupture of Membranes
-
Fatemeh Abdali
,
Simin Taghavi
,
Shabnam Vazifekhah
,
Mohammad Naghavi Behzad
,
Mohammad Mirza Aghazadeh Attari
Abstract
Preterm premature rupture of membranes (PPROM) is a condition leading to an increased risk of maternal and neonatal morbidity and mortality in pregnant women. To prevent this complication, some studies have proposed using prophylactic progesterone. However, due to lack of sufficient relevant data, there is still need for further studies in this regard. This study was performed to determine the effect of rectal progesterone on the latent phase and maternal and neonatal outcome variables in females with PPROM. During the present randomized clinical trial study (IRCT201512077676N4), a total of 120 patients with PPROM at pregnancy ages between 26 and 32 weeks were randomly assigned to 2 equal intervention and control groups. In the intervention group, progesterone suppositories (400 mg per night) were administered until delivery or completion of the 34th gestational week and was compared with placebo effect in control group. The latent phase and maternal and neonatal outcome variables were compared between the two groups. The mean age of patients was 29.56±5.66 (19-42) and 29.88±5.57 (17-40) years in the intervention and control group, respectively. The two groups were almost identical in the confounding factors. The median latent phase was 8.5 days in the intervention group vs. 5 days in the control group in the 28th-30th weeks of gestation, which was significantly higher in the intervention group (P=0.001). Among maternal and neonatal outcome variables, only the mean birth-weight was significantly higher in the intervention group than that in the controls (1609.92±417.28 gr vs. 1452.03±342.35 gr, P=0.03). Administration of progesterone suppository in patients with PPROM at gestational ages of 28 to 30 weeks is effective in elongating the latent phase and increasing birth-weight with no significant complications.
Mercer BM. Preterm premature rupture of the membranes. Obstet Gynecol 2003;101:178-93.
Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A-B, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012;379:2162-72.
Norwitz ER, Caughey AB. Progesterone supplementation and the prevention of preterm birth. Rev Obstet Gynecol 2011;4:60.
Sweet RL, Gibbs RS. Chlamydial infections. In: Sweet RL, Gibbs RS, Sweet R, Gibbs R, eds. Infectious diseases of the female genital tract. Philadelphia, PA: Lippincott Williams & Wilkins, 2002:57.
Greulich B, Tarrant B. The latent phase of labor: diagnosis and management. J Midwifery Women Health 2007;52:190-8.
Xia H, Li X, Li X, Liang H, Xu H. The clinical management and outcome of term premature rupture of membrane in East China: Results from a retrospective multicenter study. Int J Clin Exp Med 2015;8:6212-7
Ibrahimou B, Anozie C, de la Cruz C, Salihu H. Previous Preterm Birth and Current Maternal Complications as a Risk Factor of Subsequent Stillbirth. Adv Epidemiol 2015;2015:819146 8. Spittle AJ, Treyvaud K, Doyle LW, Roberts G, Lee KJ, Inder TE, et al. Early emergence of behavior and social-emotional problems in very preterm infants. J Am Acad Child Psychiatry 2009;48:909-18.
Jones M. Effect of preterm birth on airway function and lung growth. Paediatr Respir Rev 2009;10:9-11.
Linehan LA, Walsh J, Morris A, Kenny L, O’Donoghue K, Dempsey E, et al. Neonatal and maternal outcomes following midtrimester preterm premature rupture of the membranes: a retrospective cohort study. BMC Pregnancy Childbirth 2016;16:25.
Hodek J-M, von der Schulenburg J-M, Mittendorf T. Measuring economic consequences of preterm birth-Methodological recommendations for the evaluation of personal burden on children and their caregivers. Health Econ Rev 2011;1:6.
Wang P, Liou S-R, Cheng C-Y. Prediction of maternal quality of life on preterm birth and low birthweight: a longitudinal study. BMC pregnancy and childbirth. 2013;13:124.
Khooshideh M, Radi V, Hosseini R, Hosseini L. The accuracy of placental alpha-microglobuline-1 test in diagnosis of premature rupture of the membranes. Iran J Reprod Med 2015;13:355-60.
Behrman RE, Butler AS. Preterm birth: causes, consequences, and prevention. National Academies Press, 2007.
Gezer C, Ekin A, Golbasi C, Kocahakimoglu C, Bozkurt U, Dogan A, et al. Use of urea and creatinine levels in vaginal fluid for the diagnosis of preterm premature rupture of membranes and delivery interval after membrane rupture. J Matern Fetal Neonatal Med 2016;30:772-8.
Lee SM, Park KH, Jung EY, Jang JA, Yoo H-N. Frequency and clinical significance of short cervix in patients with preterm premature rupture of membranes. PloS One 2017;12:e0174657.
Brookfield KF, El-Sayed YY, Chao L, Berger V, Naqvi M, Butwick AJ. Antenatal corticosteroids for preterm premature rupture of membranes: single or repeat course? Am J Perinatol 2015;32:537-44.
Mackeen AD, Seibel‐Seamon J, Muhammad J, Baxter JK, Berghella V. Tocolytics for preterm premature rupture of membranes. Cochrane Database Syst Rev 2011;10:CD007062.
To MS, Alfirevic Z, Heath VC, Cicero S, Cacho AM, Williamson PR, et al. Cervical cerclage for prevention of preterm delivery in woman with short cervix: randomised controlled trial. Lancet 2004;363:1849-53.
Lim AC, Bloemenkamp KW, Boer K, Duvekot JJ, Erwich JJH, Hasaart TH, et al. Progesterone for the prevention of preterm birth in women with multiple pregnancies: the AMPHIA trial. BMC Pregnancy Childbirth 2007;7:7.
How HY, Sibai BM. Progesterone for the prevention of preterm birth: indications, when to initiate, efficacy and safety. Ther Clin Risk Manag 2009;5:55-64.
Kumar P, Magon N. Hormones in pregnancy. Niger Med J 2012;53:179.
Luo G, Abrahams VM, Tadesse S, Funai EF, Hodgson EJ, Gao J, et al. Progesterone inhibits basal and TNF-α-induced apoptosis in fetal membranes: a novel mechanism to explain progesterone-mediated prevention of preterm birth. Reprod Sci 2010;17:532-9.
Briery CM, Veillon EW, Klauser CK, Martin RW, Magann EF, Chauhan SP, et al. Women with preterm premature rupture of the membranes do not benefit from weekly progesterone. Am J Obstet Gynecol 2011;204:54. e1-.e5.
Caughey AB, Robinson JN, Norwitz ER. Contemporary diagnosis and management of preterm premature rupture of membranes. Rev Obstet Gynecol 2008;1:11-22.
Shahnazi M, Khalili AF, Azimi S. Effect of Zinc Supplement on Prevention of PPROM and Improvement of some Pregnancy Outcomes in Pregnant Women with a History of PPROM: A Randomized Double-Blind Controlled Trial. Iran Red Crescent Med J 2017;19:e41931.
Kelly AJ, Kavanagh J, Thomas J. Castor oil, bath and/or enema for cervical priming and induction of labour. Cochrane Database Syst Rev 2013;:CD003099.
Abdelazim IA, Makhlouf HH. Placental alpha microglobulin-1 (AmniSure® test) for detection of premature rupture of fetal membranes. Arch Gynecol Obstet 2012;285:985-9.
Norman JE, Marlow N, Messow C-M, Shennan A, Bennett PR, Thornton S, et al. Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study): a multicentre, randomised, double-blind trial. Lancet 2016;387:2106-16.
Meis PJ, Klebanoff M, Thom E, Dombrowski MP, Sibai B, Moawad AH, et al. Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate. N Engl J Med 2003;348:2379-85.
da Fonseca EB, Bittar RE, Carvalho MH, Zugaib M. Prophylactic administration of progesterone by vaginal suppository to reduce the incidence of spontaneous preterm birth in women at increased risk: a randomized placebo-controlled double-blind study. Am J Obstet Gynecol 2003;188:419-24.
Mirzaei F, Moradi P. Effects of Progesterone on Latency Period in Patients with Preterm Premature Rupture of Membranes during 24-34 Weeks of Pregnancy. J Kerman Univ Med Sci 2015;22:240-8.
Maher MA, Abdelaziz A, Ellaithy M, Bazeed MF.Prevention of preterm birth: a randomized trial of vaginal compared with intramuscular progesterone. Acta Obstet Gynecol Scand 2013;92:215-22.
Crane SS, Naples R, Grand CK, Friebert S, McNinch NL, Kantak A, et al. Assessment of adherence to guidelines for using progesterone to prevent recurrent preterm birth. J Matern Fetal Med 2016;29:1861-5.
| Files | ||
| Issue | Vol 55, No 12 (2017) | |
| Section | Articles | |
| Keywords | ||
| Preterm premature rupture of membranes PPROM Progesterone Latent phase | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
