Preterm Labor and Progesterone

10/25/07 • 0 min

Guest: Alan Peaceman, MD
Host: Lisa Mazzullo, MD

Preterm labor and delivery has an enormous impact on medical society and society in general. In fact, 12% of all deliveries in the United States occur before 37 weeks gestation, which makes preterm delivery the greatest contributor to neonatal morbidity and mortality. Dr. Alan Peaceman, Professor of Obstetrics and Gynecology at Northwestern University’s Feinberg School of Medicine and chief of the MFM division, joins us to discuss the challenges of predicting and preventing preterm birth. Explore with us the new trends in medical therapy that can help significantly reduce the incidence of preterm birth with progesterone. The limitations and promise of biochemical markers, such as fetal fibronectin, and clinical predictors, such as ultrasound measured cervical length for subsequent preterm birth are also reviewed. Progesterone Protocol Information about the use of progesterone therapy can be found on the ACOG website, October 31, 2003 Reference Articles: 1. Peaceman, AM, et al. Fetal fibronectin as a predictor of preterm patients with symptoms; a multicenter trial. Am Journal of Ob/Gyn 1997;177:13-18 2. Adams, Melissa, et al. Rates of and factors associated with recurrence of preterm delivery, JAMA, 2000;283:1591 Articles of interest on the topic of preterm labor management include: 1. Wapner, Ronald, et al. ...

Guest: Alan Peaceman, MD
Host: Lisa Mazzullo, MD

Previous Episode

Challenges in Treating Polycystic Ovarian Syndrome

Guest: Sam Thatcher, MD, PhD
Host: Lisa Mazzullo, MD
Anovulation is a significant challenge for reproductive age women. The most common endocrinologic cause of this is PCOS. With the help of Dr. Sam Thatcher, pioneer in IVF technology and director of the Center for Applied Reproductive Science, we explore the exciting new possibilities and not-so-new controversies that exist with regard to treatment for PCOS patients. Helpful information about the medical therapies available for patients with PCOS such as clomid, metformin and oral contraceptives are presented. He also disputes the ‘one size fits all” theory when it comes to the care of women with PCOS. Reference material: 1. Legro, RS et al. Clomiphene, metformin or both for fertility in PCOS. N Engl J Med 2007; 356:551-56

Next Episode

Elective Cesarean Section

Guest: Alan Peaceman, MD
Host: Lisa Mazzullo, MD
Cesarean section on maternal request is becoming a more common discussion in doctors offices around the country. Since the late 90’s, cesarean section rates continue to rise with overall estimates of 29% noted in 2004. The ethics of patient autonomy war with medical concerns about potentially unnecessary surgery. The challenges posed by elective cesarean section are discussed with Dr. Alan Peaceman, professor of ob/gyn at Northwestern University Feinberg School of Medicine and chief of the division of MFM. Neonatal and maternal safety, long term sequelae of vaginal birth and NIH recommendations on how to deal with this potentially emotional issue are thoroughly discussed. Reference Articles 1. Declercq, E, PhD, et al. Factors associated with the rise in Primary Cesarean Births in the US in 2002, Am J Public Health, 2006; 96(5): 867-872 2. National Institute of Health- Cesarean Childbirth. UDHHS- 2006, , 1982-2067 3. Greene, M. et al. Vaginal Delivery after Cesarean section – is the risk acceptable? N Engl J Med 2001, 345:55-56 4. Andrist, Linda, PhD, RNC. NPWH 2006- Cesarean Section on Maternal Request_ the debate.