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Progesterone in Expectantly Managed Early-onset Preeclampsia

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Länken sparas på Urklipp
StatusRekrytering
Sponsorer
Assiut University

Nyckelord

Abstrakt

Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks' gestation and can present as late as 4-6 weeks postpartum

Beskrivning

Currently there is no effective treatment for early-onset preeclampsia except for early delivery of the fetus along with the placenta. Progesterone supplementation in the form of 17-alpha-hydroxyprogesterone caproate (17-OHPC) is currently used obstetrically to prevent recurrent preterm birth in patients with pregnancies not complicated by preeclampsia. Previous studies reported that patients with severe PE had significantly lower serum progesterone concentrations than gestational age- and race-matched non-preeclamptics. Moreover, supplementation of placental ischemic rats with 17-OHPC decreased blood pressure, inflammatory cytokines, and ET-1 within 24 hours of treatment

Datum

Senast verifierad: 02/29/2020
Först skickat: 08/31/2019
Beräknad anmälan inlämnad: 08/31/2019
Först publicerad: 09/03/2019
Senaste uppdatering skickad: 03/22/2020
Senaste uppdatering publicerad: 03/24/2020
Faktiskt startdatum för studien: 12/14/2019
Uppskattat primärt slutdatum: 05/31/2021
Beräknat slutfört datum: 09/30/2021

Tillstånd eller sjukdom

Preeclampsia

Intervention / behandling

Drug: study group

Fas

Fas 4

Armgrupper

ÄrmIntervention / behandling
Experimental: study group
women will be given 17-OHPC 250 mg intra-muscular at admission and every 7 days thereafter in addition to other conservative measures of early-onset PE
Drug: study group
Intramuscular injection 250 mg
No Intervention: control group
No intervention will be given apart from the usual conservative measures of early-onset PE

Urvalskriterier

Kön som är berättigade till studierFemale
Accepterar friska volontärerJa
Kriterier

Inclusion Criteria:

- Gestational age between 20+0 and 33+6 weeks.

- Singleton pregnancy.

- Willing to participate in the study and sign the informed consent.

Exclusion Criteria:

- Maternal compromise requiring emergent delivery (ongoing placental abruption, DIC, pulmonary edema).

- Fetal compromise requiring emergent delivery (fetal bradycardia, recurrent late fetal heart rate decelerations).

- Platelet count < 100,000/microliter (thrombocytopenia) with evidence of HELLP syndrome;

- Persistently abnormal hepatic enzyme concentrations (twice or more upper normal values);

- Severe fetal growth restriction (ultrasound-estimated fetal weight less than fifth percentile);

- Severe Oligohydramnios (AFI < 5cm)

- Reversal of end diastolic flow(REDF) in umbilical artery Doppler testing;

- Eclampsia;

- Nonreassuring fetal status during daily testing (biophysical profile <4/10 and/or recurrent variable or late decelerations);

- Intrauterine fetal death.

- Patient is unable or unwilling to give consent.

- Patients currently using progesterone for other indications.

Resultat

Primära resultatåtgärder

1. The mean difference between blood pressure measurements in both groups [one month]

blood pressure measured by mercury sphygmomanometer

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