Progestin treatment for the prevention of preterm birth.

Progestin treatment for the prevention of preterm birth.
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DOI:
10.1111/j.1600-0412.2011.01178.x
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发表时间:
2011-10
影响因子:
4.3
通讯作者:
Garfield RE
Garfield RE
中科院分区:
医学2区
文献类型:
--
作者:
Lucovnik M;Kuon RJ;Chambliss LR;Maner WL;Shi SQ;Shi L;Balducci J;Garfield RE

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考虑到孕酮在维持妊娠中的作用以及基础和临床研究的支持,补充孕酮似乎是一种有希望的方法,既可以预防早产的发生,也可以在早产发生后进行治疗。孕酮和17-α-羟孕酮-乙酸酯(17-OH P)减缓宫颈成熟的过程,这是迄今为止研究最多的预防性长期补充孕酮的基本原理。然而,孕酮(而不是17-OH P)也抑制子宫肌层的活动,即使在子宫颈已经成熟。此外,这些作用在很大程度上取决于所用的媒介物和给药途径。了解不同的作用机制,以及孕激素制剂、载体和给药途径的重要性,是找到预防早产的最佳孕激素治疗的关键。
Progestin supplementation appears to be a promising approach to both preventing initiation of preterm labor and treating it once it is already established, given progesterone’s role in maintaining pregnancy as well as support from basic and clinical research. Progesterone and 17- alpha-hydroxyprogesterone-acetate (17-OH P) slow the process of cervical ripening and this is the rationale for prophylactic long-term progestin supplementation mostly studied so far. However, progesterone (but not 17-OH P) also inhibits myometrial activity even after the cervix is already ripened. Moreover, these effects depend greatly on the vehicle used and the route of administration. Understanding different mechanisms of action, as well as the importance of progestin formulation, vehicle, and route of administration is the key to finding the optimal progestin treatment for prevention of preterm birth.
DOI: 10.1016/0002-9378(60)90381-1
发表时间: 1960-01-01
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