Abstract:
:Progesterone is essential for the maintenance of pregnancy. Several small trials have suggested that progesterone supplementation may reduce the risk of miscarriage in women with recurrent or threatened miscarriage. Cochrane Reviews summarized the evidence and found that the trials were small with substantial methodologic weaknesses. Since then, the effects of first-trimester use of vaginal micronized progesterone have been evaluated in 2 large, high-quality, multicenter placebo-controlled trials, one targeting women with unexplained recurrent miscarriages (the PROMISE [PROgesterone in recurrent MIScarriagE] trial) and the other targeting women with early pregnancy bleeding (the PRISM [PRogesterone In Spontaneous Miscarriage] trial). The PROMISE trial studied 836 women from 45 hospitals in the United Kingdom and the Netherlands and found a 3% greater live birth rate with progesterone but with substantial statistical uncertainty. The PRISM trial studied 4153 women from 48 hospitals in the United Kingdom and found a 3% greater live birth rate with progesterone, but with a P value of .08. A key finding, first observed in the PROMISE trial, and then replicated in the PRISM trial, was that treatment with vaginal micronized progesterone 400 mg twice daily was associated with increasing live birth rates according to the number of previous miscarriages. Prespecified PRISM trial subgroup analysis in women with the dual risk factors of previous miscarriage(s) and current pregnancy bleeding fulfilled all 11 conditions for credible subgroup analysis. For the subgroup of women with a history of 1 or more miscarriage(s) and current pregnancy bleeding, the live birth rate was 75% (689/914) with progesterone vs 70% (619/886) with placebo (rate difference 5%; risk ratio, 1.09, 95% confidence interval, 1.03-1.15; P=.003). The benefit was greater for the subgroup of women with 3 or more previous miscarriages and current pregnancy bleeding; live birth rate was 72% (98/137) with progesterone vs 57% (85/148) with placebo (rate difference 15%; risk ratio, 1.28, 95% confidence interval, 1.08-1.51; P=.004). No short-term safety concerns were identified from the PROMISE and PRISM trials. Therefore, women with a history of miscarriage who present with bleeding in early pregnancy may benefit from the use of vaginal micronized progesterone 400 mg twice daily. Women and their care providers should use the findings for shared decision-making.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Coomarasamy A,Devall AJ,Brosens JJ,Quenby S,Stephenson MD,Sierra S,Christiansen OB,Small R,Brewin J,Roberts TE,Dhillon-Smith R,Harb H,Noordali H,Papadopoulou A,Eapen A,Prior M,Di Renzo GC,Hinshaw K,Mol BW,Lumsden MAdoi
10.1016/j.ajog.2019.12.006subject
Has Abstractpub_date
2020-08-01 00:00:00pages
167-176issue
2eissn
0002-9378issn
1097-6868pii
S0002-9378(19)32762-0journal_volume
223pub_type
杂志文章,评审abstract::Oral contraceptives (OCs) raise the plasma levels of some clotting factors, especially factor VII. Until recently, however, there has been no evidence for a relationship between high levels of clotting factor and the onset of clinically manifest vascular disease. It has not been established, on a preliminary basis, th...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32484-x
更新日期:1982-03-15 00:00:00
abstract::Twelve cases of retroperitoneal mucinous cystadenoma or mucinous cystadenocarcinoma in women have been reported in the literature. We report an additional case. The histogenesis of mucinous cystadenomas and mucinous cystadenocarcinomas in the retroperitoneum is not clear, but that these lesions may arise from teratoma...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90201-9
更新日期:1989-05-01 00:00:00
abstract::The serum concentration of ferritin in 11 patients with toxemia of pregnancy was compared to that of normal women in the early third trimester of pregnancy and in labor at term. The mean concentration of ferritin for toxemic patients was 91.8 ng/ml compared to 18.4 ng/ml and 19.4 ng/ml for the two control groups, resp...
journal_title:American journal of obstetrics and gynecology
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doi:10.1016/0002-9378(82)90247-2
更新日期:1982-10-15 00:00:00
abstract:OBJECTIVE:We sought to compare the outcomes of cervicoisthmic (CI) cerclage using traditional transabdominal (TA) approach vs the lesser used transvaginal (TV) approach. STUDY DESIGN:We conducted a retrospective cohort study of women who underwent placement of a CI cerclage. RESULTS:Before CI placement, the abdominal...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.03.020
更新日期:2009-07-01 00:00:00
abstract::Cholesterol metabolism was studied in cells from two established gynecologic cancer cell lines which were maintained in monolayer cultures. The cell lines were derived and established from poorly differentiated epidermoid cervical carcinoma (EC-50) and endometrial adenocarcinoma (AC-258). The specific activity of 3-hy...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90952-2
更新日期:1981-04-15 00:00:00
abstract:OBJECTIVE:Our purpose was to evaluate the efficacy and consequences of sacrospinous ligament suspension and pelvic reconstruction. STUDY DESIGN:Patients who underwent sacrospinous ligament suspension between 1978 and 1991 were evaluated from follow-up visits, telephone interviews, questionnaires, and chart reviews. Be...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70085-6
更新日期:1996-12-01 00:00:00
abstract::Oxytocin concentrations were determined in baboon (Papio anubis) corpora lutea, and the effect of oxytocin on dispersed luteal cell progesterone production was evaluated. Oxytocin concentrations increased significantly from an early luteal phase value of 2.1 +/- 1.1 ng/gm to a peak concentration of 18.1 +/- 4.3 ng/gm ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90089-0
更新日期:1988-04-01 00:00:00
abstract::The American College of Women's Health Physicians has been exploring an on-line educational tool-concept mapping-to facilitate the development of an interdisciplinary and woman-centered women's health curriculum, and to implement The Women's Health Care Competencies for Medical Students. By using an on-line concept ma...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.127360
更新日期:2002-09-01 00:00:00
abstract::Swan-Ganz catheterization was performed in 15 postpartum women who presented with severe pregnancy-induced hypertension at a mean gestational age of 31.5 weeks. The mean arterial pressure on presentation was 137.6 torr (range, 116 to 167 torr), and it remained at approximately 115 torr for the next 72 hours. Serial pu...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90750-6
更新日期:1984-03-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
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更新日期:2018-02-01 00:00:00
abstract::To identify causes and risk factors for pregnancy-related mortality in New York City, we analyzed 224 pregnancy-related deaths that occurred from 1980 to 1984. The leading causes of death were ectopic pregnancy complications, embolism, intrapartum cardiac arrest, and hypertension. Mortality ratios were determined by c...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)80031-1
更新日期:1991-02-01 00:00:00
abstract::We report a case of placenta accreta that was managed conservatively by uterine arterial embolization and subsequently was complicated by hematuria. Ultrasound revealed a calcified mass at the posterior bladder wall. A careful resection under cystoscopy was carried out without hemorrhagic complication. Pathologic exam...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.08.040
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to evaluate the attitude of anesthesiologists and gynecologists to the use of blood during cesarean section operation and, on the basis of the results, to ascertain the need for improvement of current transfusion guidelines. STUDY DESIGN:A scenario-based survey was performed. RESUL...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2003.07.028
更新日期:2004-02-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1067/mob.2002.123768
更新日期:2002-08-01 00:00:00
abstract::The maturation of the glomerular filtration rate (GFR) and the interrelationship between the GFR and the renal transport of sodium and chloride have been evaluated during the last trimester of gestation with the use of long-term experiments in fetal lambs. An increase in GFR (milliliters per minute) parallel to the in...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90712-8
更新日期:1977-08-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.348
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:Because there is a dearth of literature, we developed an ethical framework to guide decision making about the management of pregnancy of patients with schizophrenia. STUDY DESIGN:We review pertinent literature on schizophrenia and pregnancy, including information on maternal and fetal risks and outcomes, and...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.125767
更新日期:2002-09-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.01.031
更新日期:2007-04-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
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更新日期:1995-10-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.03.082
更新日期:2004-07-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
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doi:10.1016/j.ajog.2014.06.032
更新日期:2014-12-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(80)90084-8
更新日期:1980-11-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the long-term impact of anal sphincter laceration on anal incontinence. STUDY DESIGN:Five to 10 years after first delivery, anal incontinence and other bowel symptoms were measured with the Epidemiology of Prolapse and Incontinence Questionnaire and the short form...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.06.055
更新日期:2012-11-01 00:00:00
abstract::A study comparing the efficacy of cefotetan versus cefoxitin for prophylaxis in patients undergoing cesarean section was carried out at the University of Iowa. After institutional review, 36 subjects who met the study criteria and agreed to participate were entered into the study; of these, 29 were evaluable for effic...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
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更新日期:1986-04-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2006.10.885
更新日期:2007-05-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90281-7
更新日期:1981-06-01 00:00:00
abstract::Based on epidemiologic data, women who take oral contraceptives seem to have an increased risk of developing thromboembolic disease. In order to explain this association, some studies have been undertaken to find abnormalities in the hemostasis system. Many conflicting test results have been reported, probably reflect...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
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更新日期:1982-03-15 00:00:00
abstract:OBJECTIVE:We examined trends in overall and preoperative urodynamics utilization among women with stress urinary incontinence (SUI) to determine if practice patterns changed following publication of a 2012 randomized trial questioning the value of preoperative urodynamics in patients with uncomplicated SUI. STUDY DESI...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2015.06.062
更新日期:2015-11-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)91672-x
更新日期:1992-07-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90627-1
更新日期:1985-07-01 00:00:00