کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6146531 | 1594949 | 2012 | 19 صفحه PDF | دانلود رایگان |

ObjectiveTo determine whether the use of vaginal progesterone in asymptomatic women with a sonographic short cervix (â¤25 mm) in the midtrimester reduces the risk of preterm birth and improves neonatal morbidity and mortality.Study DesignIndividual patient data metaanalysis of randomized controlled trials.ResultsFive trials of high quality were included with a total of 775 women and 827 infants. Treatment with vaginal progesterone was associated with a significant reduction in the rate of preterm birth <33 weeks (relative risk [RR], 0.58; 95% confidence interval [CI], 0.42-0.80), <35 weeks (RR, 0.69; 95% CI, 0.55-0.88), and <28 weeks (RR, 0.50; 95% CI, 0.30-0.81); respiratory distress syndrome (RR, 0.48; 95% CI, 0.30-0.76); composite neonatal morbidity and mortality (RR, 0.57; 95% CI, 0.40-0.81); birthweight <1500 g (RR, 0.55; 95% CI, 0.38-0.80); admission to neonatal intensive care unit (RR, 0.75; 95% CI, 0.59-0.94); and requirement for mechanical ventilation (RR, 0.66; 95% CI, 0.44-0.98). There were no significant differences between the vaginal progesterone and placebo groups in the rate of adverse maternal events or congenital anomalies.ConclusionVaginal progesterone administration to asymptomatic women with a sonographic short cervix reduces the risk of preterm birth and neonatal morbidity and mortality.
Journal: American Journal of Obstetrics and Gynecology - Volume 206, Issue 2, February 2012, Pages 124.e1-124.e19