Friday December 14, 2018

Drug prescribed to Pregnant Women with history of delivering Premature Babies may do more Harm than Good: Study

The drug, mostly prescribed to pregnant women with a history of delivering premture babies may even increase the risk of developing gestational diabetes

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New York, March 15, 2017: A drug commonly prescribed to pregnant women with a history of delivering premature babies may do more harm than good, says a study.

Far from providing any benefit, this drug — known by the brand name Makena — may even increase the risk of developing gestational diabetes, said the study published online in the American Journal of Obstetrics and Gynecology.

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“Our study showed the drug to be ineffective, and it has a side effect,” said first author of the study David Nelson, Assistant Professor of Obstetrics and Gynecology at University of Texas Southwestern Medical Center (UT Southwestern) in the US.

The drug, a synthetic progestogen hormone called 17-alpha hydroxyprogesterone caproate, was approved by the US Food and Drug Administration (FDA) in 2011 to treat women at risk of delivering a second premature baby.

The FDA gave the drug accelerated approval in part due to findings in a 2003 study published in The New England Journal of Medicine that the drug reduced the likelihood of a repeat preterm delivery.

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However, Makena has been a source of debate among doctors because of the questions raised about the 2003 findings.

Earlier research findings on the benefit of 17-OHPC have been mixed, said Kenneth Leveno, senior author of the study and Professor of Obstetrics and Gynecology at UT Southwestern.

In the newly published study, pregnant women treated at Parkland Memorial Hospital, were offered the drug 17-alpha hydroxyprogesterone caproate (17-OHPC) if they had a prior history of premature births and were carrying a single fetus.

The research took place from 2012 to 2016 and followed 430 women treated with the drug.

Researchers then compared the premature birth rate of those women with the historical premature birth rate of 5,787 patients seen at Parkland between 1988 and 2011 — women who also had a history of premature delivery but never took the drug.

Of the women in the study group who took the drug, 25 per cent had a premature delivery.

That compared with a 16.8 per cent preterm birth rate in the historical nondrug group.

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The rate of gestational diabetes was 13.4 per cent in women treated with the drug, compared with eight per cent in the other group, the study found.

Gestational diabetes often goes away after the birth, and therefore is not usually a serious problem for the mother, Nelson said.

However, it can lead to deliveries of larger babies and increased chances for cesarean sections and other birth complications. (IANS)

 

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First Successful Case Of Womb Transplant in Brazil

In the Brazilian case, the recipient had been born without a uterus due to a condition called Mayer-Rokitansky-Küster-Hauser syndrome. The donor was 45 and died of a stroke.

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Womb Transplant
Medical team hold the first baby born via uterus transplant from a deceased donor at the hospital in Sao Paulo, Brazil. VOA

A woman in Brazil who received a womb transplanted from a deceased donor has given birth to a baby girl in the first successful case of its kind, doctors reported.

The case, published in The Lancet medical journal, involved connecting veins from the donor uterus with the recipient’s veins, as well as linking arteries, ligaments and vaginal canals.

It comes after 10 previously known cases of uterus transplants from deceased donors – in the United States, the Czech Republic and Turkey – failed to produce a live birth.

The girl born in the Brazilian case was delivered via caesarean section at 35 weeks and three days, and weighed 2,550 grams (nearly 6 lbs), the case study said.

Dani Ejzenberg, a doctor at Brazil’s Sao Paulo University hospital who led the research, said the transplant – carried out in September 2016 when the recipient was 32 – shows the technique is feasible and could offer women with uterine infertility access to a larger pool of potential donors.

Womb
. The woman’s previously fertilized and frozen eggs were implanted after seven months and 10 days later she was confirmed pregnant.. Pixabay

The current norm for receiving a womb transplant is that the organ would come from a live family member willing to donate it.

“The numbers of people willing and committed to donate organs upon their own deaths are far larger than those of live donors, offering a much wider potential donor population,” Ejzenberg said in a statement about the results.

She added, however, that the outcomes and effects of womb donations from live and deceased donors have yet to be compared, and said the technique could still be refined and optimised.

The first baby born after a live donor womb transplant was in Sweden in 2013. Scientists have so far reported a total of 39 procedures of this kind, resulting in 11 live births.

Experts estimate that infertility affects around 10 to 15 percent of couples of reproductive age worldwide. Of this group, around one in 500 women have uterine problems.

Before uterus transplants became possible, the only options to have a child were adoption or surrogacy.

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The case, published in The Lancet medical journal, involved connecting veins from the donor uterus with the recipient’s veins. Pixabay

In the Brazilian case, the recipient had been born without a uterus due to a condition called Mayer-Rokitansky-Küster-Hauser syndrome. The donor was 45 and died of a stroke.

Also Read: Pregnancy is Possible For Survivors of Breast Cancer

Five months after the transplant, Ejzenberg’s team wrote, the uterus showed no signs of rejection, ultrasound scans were normal, and the recipient was having regular menstruation. The woman’s previously fertilized and frozen eggs were implanted after seven months and 10 days later she was confirmed pregnant.

At seven months and 20 days – when the case study report was submitted to The Lancet – the baby girl was continuing to breastfeed and weighed 7.2 kg (16 lb). (VOA)