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Journal of the Chinese Medical... May 2020
Topics: Female; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Obstetric Labor, Premature; Pregnancy; Risk Factors
PubMed: 32168077
DOI: 10.1097/JCMA.0000000000000296 -
Journal of Perinatal Medicine Nov 2017
Topics: Delivery, Obstetric; Female; Humans; Infant, Newborn; Obstetric Labor, Premature; Outcome Assessment, Health Care; Perinatal Care; Pregnancy; Premature Birth; Risk Factors
PubMed: 29055176
DOI: 10.1515/jpm-2017-0298 -
Seminars in Perinatology Nov 2017Preterm labor with intact membranes is a major cause of spontaneous preterm birth (sPTB). To prevent sPTB a clear understanding is needed of the hormonal interactions... (Review)
Review
Preterm labor with intact membranes is a major cause of spontaneous preterm birth (sPTB). To prevent sPTB a clear understanding is needed of the hormonal interactions that initiate labor. The steroid hormone progesterone acting via its nuclear progesterone receptors (PRs) in uterine cells is essential for the establishment and maintenance of pregnancy and disruption of PR signaling (i.e., functional progesterone/PR withdrawal) is key trigger for labor. The process of parturition is also associated with inflammation within the uterine tissues and it is now generally accepted that inflammatory stimuli from multiple extrinsic and intrinsic sources induce labor. Recent studies suggest inflammatory stimuli induce labor by affecting PR transcriptional activity in uterine cells to cause functional progesterone/PR withdrawal. Advances in understanding the functional interaction of inflammatory load on the pregnancy uterus and progesterone/PR signaling is opening novel areas of research and may lead to rational therapeutic strategies to effectively prevent sPTB.
Topics: Female; Humans; Infant, Newborn; Inflammation; Obstetric Labor, Premature; Parturition; Pregnancy; Premature Birth; Progesterone; Receptors, Progesterone; Reproductive Health; Signal Transduction; Uterus
PubMed: 28889957
DOI: 10.1053/j.semperi.2017.07.013 -
MCN. the American Journal of Maternal... 2020
Review
Topics: Female; Humans; Infant, Newborn; Mass Screening; Obstetric Labor, Premature; Pregnancy; Risk Factors
PubMed: 33074921
DOI: 10.1097/NMC.0000000000000685 -
Clinics in Perinatology Jun 2019Preterm birth can be medically-indicated or spontaneous. Almost half of spontaneous preterm deliveries are preceded by preterm labor. Preterm labor is a clinical... (Review)
Review
Preterm birth can be medically-indicated or spontaneous. Almost half of spontaneous preterm deliveries are preceded by preterm labor. Preterm labor is a clinical diagnosis characterized by regular uterine contractions (painful or painless) with concomitant cervical change. This article discusses the prevention and treatment of spontaneous preterm labor utilizing progesterone and tocolytic agents and provides management recommendations in patients with and without a history of prior spontaneous preterm birth.
Topics: Adrenergic beta-Agonists; Anti-Inflammatory Agents, Non-Steroidal; Calcium Channel Blockers; Cyclooxygenase Inhibitors; Female; Humans; Magnesium Sulfate; Nitric Oxide Donors; Obstetric Labor, Premature; Pregnancy; Progesterone; Progestins; Receptors, Oxytocin; Tocolytic Agents
PubMed: 31010553
DOI: 10.1016/j.clp.2019.02.001 -
Journal of Perinatal Medicine Jul 2016
Topics: Female; Humans; Infant, Newborn; Infant, Premature; Obstetric Labor, Premature; Perinatal Care; Pregnancy; Premature Birth
PubMed: 27362957
DOI: 10.1515/jpm-2016-0202 -
BioMed Research International 2019
Topics: Africa South of the Sahara; Asia, Southeastern; Female; Humans; Obstetric Labor, Premature; Pregnancy; Premature Birth
PubMed: 31211139
DOI: 10.1155/2019/4870938 -
American Journal of Obstetrics and... Dec 2018
Topics: Aspirin; Female; Humans; Infant, Newborn; Obstetric Labor, Premature; Pre-Eclampsia; Pregnancy; Premature Birth
PubMed: 30144402
DOI: 10.1016/j.ajog.2018.08.027 -
Current Opinion in Obstetrics &... Apr 2021Multifetal pregnancy carries increased risk of preterm delivery, and consensus on management options to prevent early birth in this population has not been reached. This... (Review)
Review
PURPOSE OF REVIEW
Multifetal pregnancy carries increased risk of preterm delivery, and consensus on management options to prevent early birth in this population has not been reached. This review serves to summarize the most contemporary findings on this controversial topic.
RECENT FINDINGS
Examination-indicated cerclage is effective in reducing preterm birth in twin pregnancies, whereas cerclages for other indications are less convincing. Cervical pessary may be beneficial for patients with a short cervix and in those who have had threatened preterm labor. Progesterone supplementation for multifetal gestation alone is not beneficial, but it can be considered in those with a history of prior singleton preterm birth.
SUMMARY
Interventions for preterm birth prevention in multiple gestations remain under investigation, and further data is required in order to reach consensus for this high-risk population.
Topics: Cervix Uteri; Female; Humans; Infant, Newborn; Obstetric Labor, Premature; Pessaries; Pregnancy; Pregnancy, Twin; Premature Birth
PubMed: 33427762
DOI: 10.1097/GCO.0000000000000686 -
The Journal of Maternal-fetal &... May 2017Spontaneous preterm delivery, prematurity, and low birth weight due to prematurity account for a great part of neonatal morbidity and mortality. Inflammation may cause... (Review)
Review
Spontaneous preterm delivery, prematurity, and low birth weight due to prematurity account for a great part of neonatal morbidity and mortality. Inflammation may cause preterm labor, with the involvement of different mediators that produce diverse aspects of the inflammatory response. Although bacteria are considered to be the main trigger for intrauterine infection/inflammation, immunological factors also appear to be involved. Recently, molecular genetic studies have helped us better understand the underlying pathophysiologic processes. During mammalian pregnancy, maternal-fetal tolerance involves a number of immunosuppressive factors produced by placenta. Recently, placenta-derived exosomes have emerged as new immune regulators in the maternal immune tolerance. This review focuses on the specific immune parameters that become altered during human pregnancy, the identity and function of some immune modulators that have been best characterized to date, as well as a comprehensive evaluation of the pregnancy-associated mechanisms that downregulate proinflammatory immunity to a level sufficient to prevent the triggering of premature common pathway of labor and damage to developing organs.
Topics: Amniotic Fluid; Female; Humans; Infant, Newborn; Maternal-Fetal Exchange; Obstetric Labor, Premature; Placenta; Pregnancy; Pregnancy Complications, Infectious; Premature Birth
PubMed: 27380453
DOI: 10.1080/14767058.2016.1209653