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[孕酮与早产:回归未来?]

[Progesterone and preterm delivery: back to the future?].

作者信息

Fuchs F, Audibert F, Senat M-V

机构信息

Département de gynécologie-obstétrique, CHU Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, Montréal H3T 1C5, Québec, Canada; Inserm, CESP Centre de recherche en épidémiologie et santé des populations, U1018, reproduction et développement de l'enfant, hôpital du Kremlin-Bicêtre, secteur bleu - Pierre-Lajaunias, porte 89, 82, rue du Général-Leclerc, 94276 Le Kremlin-Bicêtre cedex, France; Université Paris-Sud, UMRS 1018, hôpital du Kremlin-Bicêtre, 82, rue du Général-Leclerc, 94276 Le Kremlin-Bicêtre cedex, France.

Département de gynécologie-obstétrique, CHU Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, Montréal H3T 1C5, Québec, Canada.

出版信息

Gynecol Obstet Fertil. 2014 Feb;42(2):112-122. doi: 10.1016/j.gyobfe.2013.12.006. Epub 2014 Jan 24.

Abstract

Progesterone was widely used in France during the 1980s and 1990s to prevent preterm birth until some published cases of cholestasis suddenly stopped its prescription. Since then, multiple randomized controlled trials have emerged and demonstrated the efficiency of the treatment but also its safety at low doses. In order to clarify its indications, we performed a current literature review. We analyzed literature data according to different categories of risk and different routes of administration. Results confirm that progesterone is an efficient treatment to prevent preterm birth in singleton gestation with short cervical length, and in singleton gestation with prior preterm birth with or without short cervical length. Apart from these indications, progesterone, especially 17-alpha-hydroxyprogesterone (17OHP), should not be used outside research protocols.

摘要

20世纪80年代和90年代,孕酮在法国被广泛用于预防早产,直到一些已发表的胆汁淤积病例突然停止了其处方。从那时起,多项随机对照试验出现并证明了该治疗方法的有效性以及低剂量时的安全性。为了明确其适应症,我们进行了一项当前文献综述。我们根据不同的风险类别和不同的给药途径分析了文献数据。结果证实,孕酮是预防单胎妊娠宫颈长度短以及有或无宫颈长度短的既往早产单胎妊娠早产的有效治疗方法。除了这些适应症外,孕酮,尤其是17α-羟孕酮(17OHP),不应在研究方案之外使用。

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