孕激素补充剂以预防流产:证据和争议
Gabriele Saccone1, Vincenzo Berghella2, Moti Gulersen2
1Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
概括
孕激素补充剂可能不会防止所有女性流产. 虽然它不是普遍有益的,但它可能有助于特定的高风险群体,因此需要进一步研究个性化治疗策略.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 产科和妇科 产科和妇科
背景情况:
- 孕激素对于维持怀孕至关重要;缺乏与早期怀孕损失有关.
- 正在探索孕激素补充剂以预防流产,特别是在高风险群体中.
- 关于孕激素在预防流产方面的有效性现有的证据仍然没有确定性.
研究的目的:
- 评估孕激素补充剂在预防流产方面的整体有效性.
- 确定可能从孕激素治疗中受益的妇女的特定子组.
- 探索孕激素补充剂的最佳服用途径和治疗持续时间.
主要方法:
- 随机对照试验的元分析,包括PROMISE和PRISM研究.
- 分析活产率作为主要结果.
- 基于临床病史的子组分析,例如早期出血和先前流产.
主要成果:
- 总的来说,孕激素补充剂并没有显著改善活产率.
- 在患有早期出血和有流产史的女性中观察到潜在的益处.
- 阴道和皮下注射的疗效与肌内注射相比,耐受性更好.
结论:
- 目前的证据不支持在怀孕早期普遍补充孕激素.
- 根据临床评估,可以考虑针对高风险女性进行个性化孕激素治疗.
- 未来的研究应该专注于识别黄素缺乏标志物,并完善患者选择孕激素治疗的方法.
相关概念视频
Drugs for Peptic Ulcer Disease: Prostaglandin Analogs as Mucosal Protective Agents
1.1K
The gastric mucosa produces prostaglandins E2 (PGE2) and prostacyclin (PGI2), crucial in maintaining gastric health. They exert cytoprotective effects, including increasing bicarbonate secretion, releasing protective mucin, reducing gastric acid output, and preventing harmful vasoconstriction. These effects are mediated through various receptors, such as EP1, EP2, EP3, and EP4.
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
1.1K
Ovarian Cycle
3.4K
The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle...
3.4K
Birth Control Methods
5.8K
Vasectomy is a surgical form of male sterilization that involves severing and sealing the vasa deferentia, preventing sperm from mixing with semen during ejaculation. Because a vasectomy does not impact the testes' ability to produce testosterone, hormone levels, libido, and sexual function generally remain unchanged. While vasectomy is highly effective in preventing pregnancy, with a success rate near 99.85%, rare cases of recanalization (spontaneous reconnection) can occur. Although...
5.8K
Mitral Valve Prolapse III: Nursing Management
279
The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
279
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
1.1K
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
1.1K
Gonadal and Placental Hormones
2.7K
The gonads, namely the testes in males and the ovaries in females, are pivotal in producing gonadal hormones that orchestrate the intricate processes of sexual development and reproduction.
In males, testosterone is the primary gonadal androgen. It plays a central role in the maturation of male reproductive organs — the penis and testes. Additionally, testosterone is instrumental in the development of secondary sexual characteristics — a deep voice as well as facial and pubic hair...
In males, testosterone is the primary gonadal androgen. It plays a central role in the maturation of male reproductive organs — the penis and testes. Additionally, testosterone is instrumental in the development of secondary sexual characteristics — a deep voice as well as facial and pubic hair...
2.7K


