[Progesterone and preterm delivery: back to the future?].
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.
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. Electronic address: florentfuchs@yahoo.fr.
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Fuchs
Département de gynécologie-obstétrique, CHU Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, Montréal H3T 1C5, Québec, Canada.
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Audibert
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, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris (AP-HP), 78, rue du General-Leclerc, 94270 Le Kremlin-Bicêtre, France.
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Senat
D019326:17-alpha-Hydroxyprogesterone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000282:Administration, Intravaginal; D005260:Female; D005602:France; D006801:Humans; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology / Q000517:prevention & control*; D011374:Progesterone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D002581:Uterine Cervical Incompetence
D011374:Progesterone; D019326:17-alpha-Hydroxyprogesterone
Accouchement prématuré; Antécédent d’accouchement prématuré; Col court; Preterm birth; Prevention; Prior preterm birth; Progesterone; Progestérone; Prévention; Short cervical length