Teško je izdržati slažem se!
Tekst je interesantan jer predstavlja pokušaj objašnjava mehanizma dejstva Progesterona.
Ali evo i jednog malo većeg ispitivanja.
"Vaginal Progesterone Reduces Risk of Preterm Birth"
Laurie Barclay, MD
Medscape Medical News 2003. © 2003 Medscape
Feb. 27, 2003 — Vaginal progesterone reduces the frequency of uterine contractions and the risk of preterm birth, according to the results of a randomized trial reported in the February issue of the American Journal of Obstetrics and Gynecology.
"Preterm delivery is a leading cause of neonatal morbidity and mortality. Thus, the prevention of preterm delivery has become one of the major objectives of perinatal medicine," write Eduardo B. Da Fonseca, MD, and colleagues from the University of Sao Paulo Medical School in Brazil. "An increase in the number of uterine contractions precedes the onset of preterm labor, and the frequency of uterine contractions in pregnancies with preterm delivery is higher than in women with term and postterm delivery."
In this double-blind study, 142
women with high-risk singleton pregnancies received 100 mg progesterone or placebo daily by vaginal suppository. Between 24 and 34 weeks of gestation, all subjects had uterine contraction monitoring with an external tocodynamometer once weekly for 60 minutes.
Preterm births occurred in 30 women overall (21.1%). Compared with the placebo group, the progesterone group fared better in terms of percentage with abnormal uterine activity (23.6% vs. 54.3%); preterm births before 37 weeks (13.8% vs. 28.5%); and deliveries before 34 weeks (2.7% vs. 18.5%; P < .05 for all comparisons).
"Prophylactic vaginal progesterone reduced the frequency of uterine contractions and the rate of preterm delivery in women at high risk for prematurity," the authors write. "The role of progesterone in pregnancy is unclear; however, we know that the effect of progesterone on the myometrium is two-fold: it suppresses the action of estrogen by inhibiting the replacement of cytosolic estrogen receptors and it exerts a direct effect on the biosynthetic processes of the uterus through its own cellular receptor."
The authors note that the prophylactic use of natural progesterone may be associated with decreased uterine contractions, but that this alone cannot explain the lower rate of preterm delivery. They recommend confirming these results in multicenter randomized clinical trials.
In an accompanying editorial, associate editor Jay D. Iams, MD, agrees that the sample size is insufficient to determine whether progesterone supplementation can reduce perinatal morbidity. "Although it is not yet time to treat all women at risk for preterm birth with supplemental progesterone, it is not too soon to hope that these early reports will be followed by larger series showing not only a decline in preterm birth but a reduction in perinatal morbidity and mortality as well," he writes.
Am J Obstet Gynecol. 2003;188:419-424
Normalno da Progesteron nije čaroban lek, a i razlozi prevremenog porođaja su mnogobrojni, te ne može svuda da pomogne, ali u ovom ispitivanju prevremeni porođaj dogodio se ukupno kod 30 trudnica(21.1%). Upoređujući sa placebo grupom (bez P), "Progesteronska grupa" stoji daleko bolje, prisustvo abnormalnih uterinih aktivnosti (23.6% nasuprot 54.3%); prevremen porođaj pre 37 nedelje (13.8% nasuprot 28.5%); porođaj pre 34 nedelje (2.7% nasuprot 18.5%; P < .05 for all comparisons).
Pozdrav Dr PeđaDj