| Référence : | | |
| The Use of Isomolecular Progesterone in the Support of Pregnancy and Fetal Safety Verbatim - Proceedings of the Matthew Bulfin Educational Conference, Washington, D.C., February 21-22, 2015 .. cacher .... voir plus ..
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| Hilgers et al. Progesterone in the Support of Pregnancy .. cacher .... voir plus ..
Hilgers TW, Keefe CE, Pakiz KA. The Use of Isomolecular Progesterone in the Support of Pregnancy and Fetal Safety. Issues Law Med. 2015 Autumn;30(2):159-68
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| PROMISE: first-trimester progesterone therapy in women with a history of unexplained recurrent miscarriages – a randomised, double-blind, placebo-controlled, international multicentre trial and economic evaluation .. cacher .... voir plus ..
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| Symptome traité : | | |
| Fausse couche à répétition .. cacher .... voir plus ..
La définition des FCS précoces est variable selon les auteurs,correspondant littéralement à un arrêt de grossesse pendant la vie embryonnaire.
Les fausses couches spontanées répétées, sont définies par 2 fausses couches spontanées ou plus.
Dans plus de la majorité des cas, les couples pourront concevoir des enfants en bonne santé, sans assistance, même après avoir perdu deux grossesses.
Types de fausse couche: elles sont habituellement divisées en deux groupes: précoces et tardives.
. Les fausses couches à répétition précoces (au cours du premier trimestre) sont principalement attribuables à des problèmes génétiques ou chromosomiques de l'embryon, avec 50 à 80% des pertes spontanées ayant un nombre chromosomique anormal. Les anomalies de l'utérus peuvent également jouer un rôle dans les fausses couches précoces.
. Les fausses couches à répétition tardives peuvent être le résultat d'anomalies utérines, de problèmes auto-immuns, d'un col utérin incompétent ou d'un accouchement prématuré.
... lire plus sur ce sujet .... | | Source: T. Hilgers The M and S practice of Naprotechnology |
| Référence : | | |
| Use of progestagens during early pregnancy .. cacher .... voir plus ..
The term “progestagens” covers a group of molecules including both the natural female sex hormones Progesterone and 17-hydroxy Progesterone as well as several synthetic forms, all displaying the ability to bind Progesterone receptors., Several studies have used Progesterone and related steroids in the attempt to prevent spontaneous miscarriage, and treat recurrent miscarriage., The present paper aims to provide a comprehensive review of the literature on progestagens effects during early pregnancy. We looked only at the results from randomized controlled trials. We found and analyzed 15 trials on the prevention of recurrent miscarriage and 2 trials on the treatment of miscarriage. The results demonstrated that there is no evidence to support the routine use of progestagens for the treatment of threatened miscarriage.
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| PROMISE: first-trimester progesterone therapy in women with a history of unexplained recurrent miscarriages - a randomised, double-blind, placebo-controlled, international multicentre trial and economic evaluation .. cacher .... voir plus ..
BACKGROUND AND OBJECTIVES: Progesterone is essential to maintain a healthy
pregnancy. Guidance from the Royal College of Obstetricians and Gynaecologists
and a Cochrane review called for a definitive trial to test whether or not
progesterone therapy in the first trimester could reduce the risk of miscarriage
in women with a history of unexplained recurrent miscarriage (RM). The PROMISE
trial was conducted to answer this question. A concurrent cost-effectiveness
analysis was conducted.
DESIGN AND SETTING: A randomised, double-blind, placebo-controlled, international
multicentre study, with economic evaluation, conducted in hospital settings
across the UK (36 sites) and in the Netherlands (nine sites).
PARTICIPANTS AND INTERVENTIONS: Women with unexplained RM (three or more
first-trimester losses), aged between 18 and 39 years at randomisation,
conceiving naturally and giving informed consent, received either micronised
progesterone (Utrogestan(®), Besins Healthcare) at a dose of 400 mg (two vaginal
capsules of 200 mg) or placebo vaginal capsules twice daily, administered
vaginally from soon after a positive urinary pregnancy test (and no later than 6
weeks of gestation) until 12 completed weeks of gestation (or earlier if the
pregnancy ended before 12 weeks).
MAIN OUTCOME MEASURES: Live birth beyond 24 completed weeks of gestation (primary
outcome), clinical pregnancy at 6-8 weeks, ongoing pregnancy at 12 weeks,
miscarriage, gestation at delivery, neonatal survival at 28 days of life,
congenital abnormalities and resource use.
METHODS: Participants were randomised after confirmation of pregnancy.
Randomisation was performed online via a secure internet facility. Data were
collected on four occasions of outcome assessment after randomisation, up to 28
days after birth.
RESULTS: A total of 1568 participants were screened for eligibility. Of the 836
women randomised between 2010 and 2013, 404 received progesterone and 432
received placebo. The baseline data (age, body mass index, maternal ethnicity,
smoking status and parity) of the participants were comparable in the two arms of
the trial. The follow-up rate to primary outcome was 826 out of 836 (98.8%). The
live birth rate in the progesterone group was 65.8% (262/398) and in the placebo
group it was 63.3% (271/428), giving a relative risk of 1.04 (95% confidence
interval 0.94 to 1.15; p = 0.45). There was no evidence of a significant
difference between the groups for any of the secondary outcomes. Economic
analysis suggested a favourable incremental cost-effectiveness ratio for
decision-making but wide confidence intervals indicated a high level of
uncertainty in the health benefits. Additional sensitivity analysis suggested the
probability that progesterone would fall within the National Institute for Health
and Care Excellence's threshold of £20,000-30,000 per quality-adjusted life-year
as between 0.7145 and 0.7341.
CONCLUSIONS: There is no evidence that first-trimester progesterone therapy
improves outcomes in women with a history of unexplained RM.
LIMITATIONS: This study did not explore the effect of treatment with other
progesterone preparations or treatment during the luteal phase of the menstrual
cycle.
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