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AIM: To evaluate the effect of progesterone use on fetal fraction (FF) in non-invasive prenatal testing (NIPT) due to the threat of first trimester miscarriage. METHODS: This case control study included the pregnant who were referred to our clinic for non-invasive prenatal testing. The patients were categorized into three groups: Pregnant women with vaginal bleeding and using progesterone, pregnant women with vaginal bleeding and not using progesterone, and pregnant women without bleeding. The groups were formed by matching gestational week. Women with multiple pregnancy, BMI (body mass index) ≥25, abnormal fetal karyotype, and chronic disease were excluded from the study. Maternal characteristics, FF of the NIPT were recruited from the computer based medical records. RESULTS: A total of 10,275 NIPT tests were performed during the study period. 3% of the patients (n = 308) were found at risk of miscarriage. 100 patients with a vaginal bleeding and 50 control patients were matched. The median value of the fetal fraction ratio was found to be 6.55 in pregnant women without vaginal bleeding, 7.05 in pregnant women who had vaginal bleeding and using progesterone, and 7.3 in pregnant women who had vaginal bleeding and did not use progesterone. Although the fetal fraction ratio was found to be higher in pregnant women with vaginal bleeding and lower in progesterone users, this situation could not reach the level of statistical significance (p = 0.351). CONCLUSIONS: The fetal fraction rate in maternal blood is not affected in pregnant women who use progesterone due to vaginal bleeding in early gestational weeks.
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Aborto Espontáneo , Amenaza de Aborto , Embarazo , Femenino , Humanos , Progesterona , Estudios de Casos y Controles , Amenaza de Aborto/tratamiento farmacológico , Hemorragia Uterina , Suplementos DietéticosRESUMEN
ETHNOPHARMACOLOGICAL RELEVANCE: Threatened abortion is a common disease among women of childbearing age. Its high incidence rate and unclear etiology, seriously threaten women's physical and mental health. Shoutai Wan (STW) is a traditional Chinese medicine decoction for treating abortion. It has a long history of treating threatened abortion by tonifying the kidney and calming the fetus. However, the mechanism of STW remains unclear. AIM OF STUDY: To study the mechanism and potential benefit of STW in pregnant mice with hydrocortisone and mifepristone-induced threatened abortion. MATERIALS AND METHODS: The STW compounds were identified using gas chromatography-mass spectrometry analysis. STW-H, STW-M, or STW-L was separately given 3 mg/ml, 1.5 mg/ml and 0.75 mg/ml STW in the morning, and 2 mg/ml hydrocortisone in the afternoon from gestation day (D) 1-9 and once with 0.4 mg/kg mifepristone on D10. Didroxyprogesterone (0.1 mg/ml) and equal dose pure water were used to replace STW in didroxyprogesterone (DYD) group and model group respectively. The control group used pure water to replace STW, hydrocortisone, and mifepristone. We performed morphological and histological analyses of the maternal-fetal interface on day 10. RESULTS: The embryo loss rate in the STW-H and DYD groups was lower than that in the model group. Hematoxylin and eosin (HE) staining suggested that the morphology of maternal-fetal interface was improved in the STW-H and DYD groups. Immunohistochemical (IHC), Quantitative Reverse Transcription Polymerase Chain Reactionstaining (qRT-PCR), and Western blot (WB) results indicated that HIF-1α expression in the maternal-fetal interface of the STW-H and DYD groups was higher than that in model group. The activities of HK, PKM, LDH and the concentration of lactic acid in the STW-H and DYD groups were higher than those in model group. Furthermore, the protein and mRNA levels of HK2, PKM2, LDHA, MCT4, and GPR81 were higher in the STW-H and DYD groups than those in the model group. CONCLUSIONS: STW can reduce the pregnancy loss rate by regulating the glycolysis balance at the maternal-fetal interface of kidney deficiency threatened abortion model mice.
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Aborto Inducido , Aborto Espontáneo , Amenaza de Aborto , Embarazo , Humanos , Ratones , Femenino , Animales , Amenaza de Aborto/tratamiento farmacológico , Mifepristona/farmacología , HidrocortisonaRESUMEN
BACKGROUND: Threatened abortions are a serious health risk for women. Deferiprone tablets are commonly used in the treatment of clinical delivery. Traditional Chinese medicine, a characteristic medical system inherited for thousands of years, often applies Shoutai pills in the treatment of Threatened abortion and has achieved good results. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of Shoutai pills combined with dedrogesterone tablets for the treatment of early preterm abortion. METHODS: Electronic searches of clinical randomized controlled trials in PubMed, Web of Science, MEDLINE, EMBASE, China National Knowledge Infrastructure, Wanfang database, and China Scientific Journal Database (VIP) were conducted. References to the included literature, gray literature in Open Grey, and other relevant literature such as clinical studies registered in ClinicalTrials.gov, were also manually searched. Relevant data were extracted, and a meta-analysis was performed using Reviewer Manager 5.4. RESULTS: The results of this study will be submitted to peer-reviewed journals. CONCLUSION: This study provides high-quality evidence on the efficacy and safety of Shoutai pills in combination with dedrogesterone tablets for the treatment of preterm abortion.
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Amenaza de Aborto , Medicamentos Herbarios Chinos , Recién Nacido , Humanos , Femenino , Amenaza de Aborto/tratamiento farmacológico , Revisiones Sistemáticas como Asunto , Metaanálisis como Asunto , Medicina Tradicional China/métodos , Proyectos de Investigación , Medicamentos Herbarios Chinos/efectos adversos , Resultado del TratamientoRESUMEN
BACKGROUND: The incidence of threatened abortion (TA) is increasing due to poor diet and living habits, which brings great pressure to pregnant women and their families. Huangqin-Baizhu herb pair recorded in ancient books of traditional Chinese medicine has been widely used in the treatment of TA with remarkable effect. In this study, we will use the network pharmacology method to predict the target and mechanism of Huangqin-Baizhu herb pair. METHODS: Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform database was used to screen the active components of Huangqin-Baizhu herb pair. Pubchem and Swiss Target Prediction databases were used to predict the action targets. Genecards, OMIM, and Drugbank databases were used to predict the related targets of TA. The intersection of drug target and disease target was selected and the intersection genes were uploaded to STRING database to construct protein-protein interaction network and conduct module analysis. Metascape database was used for Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, which was imported into Cytoscape software to construct component-pathway-gene network and finally verified by molecular docking. Ethical approval and informed consent of patients are not required because the data used in this study is publicly available and does not involve individual patient data or privacy. RESULTS: The main active components of the herb pair are baicalein, flavanone, and norwogonin, etc. The main targets are AKT1, VEGFA, STAT3, MAPK1, SRC, etc. Cluster module analysis shows that the targets are related to cell metabolism, immune regulation and hormone level regulation. There were 2073, 3169, and 161 KEGG pathways involved in the biological processes, cell components, and molecular functions of Gene Ontology analysis, respectively. The main KEGG pathways involved in the intervention were HIF1 signaling pathway, PI3K-Akt signaling pathway, and Rap1 signaling pathway. Molecular docking showed that the main active components of the herb pair were well combined with the key targets. CONCLUSIONS: In this study, 42 active components, 152 potential targets and 11 key targets of Huangqin-Baizhu herb pair for the treatment of TA were revealed, participating in multiple signaling pathways such as PI3K-Akt, providing a theoretical basis for further experimental research.
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Amenaza de Aborto , Medicamentos Herbarios Chinos , Amenaza de Aborto/tratamiento farmacológico , Medicamentos Herbarios Chinos/farmacología , Medicamentos Herbarios Chinos/uso terapéutico , Femenino , Humanos , Simulación del Acoplamiento Molecular , Fosfatidilinositol 3-Quinasas , Embarazo , Proteínas Proto-Oncogénicas c-akt , Scutellaria baicalensisRESUMEN
Objective: To explore the effect of dydrogesterone tablets combined with Zishen Yutai pills on threatened abortion in early pregnancy and pregnancy outcomes. Methods: This study retrospectively analyzed the clinical data of 100 patients with threatened abortion in early pregnancy who came to the Linhai Second People's Hospital/Taizhou Municipal Hospital from January 13, 2021, to January 13, 2022. According to different treatment methods, 48 patients treated with progesterone injection were assigned to the control group (CG), while 52 cases with the combined therapy of dydrogesterone tablets and Zishen Yutai pills were assigned to the observation group (OG). The two groups were compared in terms of the following parameters: treatment efficacy, whole blood high shear viscosity, hematocrit (HCT), plasma fibrinogen (FIB) level, spiral artery pulsatility index (PI), uterine spiral artery blood flow resistance index (RI), lumbar and abdominal pain relief time, hemostasis time, estrogen levels, pregnancy outcomes, neonatal adverse outcomes, and incidence of adverse reactions. Results: Compared with CG, the therapeutic effect in OG was observed to be evidently better, and its pain relief time and hemostasis time in the waist and abdomen were markedly shorter. After treatment, the whole blood high shear viscosity, FIB, RI, PI, and estrogen levels of both groups improved statistically compared with those before treatment, with more significant improvements in OG compared with CG. OG was also superior to CG with markedly lower incidence of preterm birth, miscarriage, neonatal adverse outcomes, and adverse reactions and a drastically higher full-term pregnancy rate. Conclusion: Zishen Yutai pill combined with dydrogesterone tablets is of remarkable therapeutic effect in treatment of early threatened abortion, which can significantly improve clinical symptoms and pregnancy outcomes of patients, with a high safety profile, which is worthy of clinical application.
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Amenaza de Aborto , Nacimiento Prematuro , Amenaza de Aborto/tratamiento farmacológico , Medicamentos Herbarios Chinos , Didrogesterona/farmacología , Didrogesterona/uso terapéutico , Estrógenos , Femenino , Humanos , Recién Nacido , Embarazo , Resultado del Embarazo , Nacimiento Prematuro/tratamiento farmacológico , Estudios Retrospectivos , Comprimidos/uso terapéuticoRESUMEN
Jiao-Ai Decoction (JAD), a classical traditional Chinese formula composed of seven Chinese herbs, has been widely used in clinical practice for the treatment of abortion for a long time. However, the material basis and pharmacological mechanism remain unclear. An integrative method combining ultra-performance liquid chromatography coupled with mass spectrometry (UPLC-MS/MS) analysis and therapeutic effect evaluation based on the hypothalamus-pituitary-ovarian axis (HPOA) was employed to elaborate these problems. Firstly, the chemical profile of JAD was identified by UPLC-Q-TOF-MS. Secondly, the main target ingredients from JAD were determined by UPLC-T-Q-MS. Finally, the miscarriage prevention of JAD on threatened abortion pregnant rats induced by mifepristone was investigated. Threatened abortion model in rats were replicated, uterine bleeding quantity (UBQ) and histopathological sections were measured, the contents of luteinizing hormone (LH), follicular stimulating hormone (FSH), estradiol (E2) and progesterone (P) were determined by ELISA, related genes and protein expression levels were detected by RT-PCR and western blotting. As a result, a total of 101 compounds were identified and 27 ingredients were determined to evaluate the quality of JAD. In the model rats, JAD could effectively regulate the HPOA to achieve miscarriage prevention, and the mechanism might be related to the regulation of gene and protein expression on the HPOA. This work could provide a novel and valuable approach for the quality evaluation of JAD and were expected to provide ideas and methods for the basic research on the scientific application of similar traditional Chinese medicine prescriptions.
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Aborto Espontáneo , Amenaza de Aborto , Medicamentos Herbarios Chinos , Aborto Espontáneo/tratamiento farmacológico , Amenaza de Aborto/tratamiento farmacológico , Amenaza de Aborto/prevención & control , Animales , China , Cromatografía Líquida de Alta Presión/métodos , Cromatografía Liquida , Medicamentos Herbarios Chinos/análisis , Femenino , Humanos , Embarazo , Ratas , Espectrometría de Masas en Tándem/métodosRESUMEN
INTRODUCTION: Threatened miscarriages is a common complication of first-trimester pregnancy. Due to the beneficial effects, there are increasing clinical studies on Yunkang oral liquid(YKOL). However, the efficacy and safety of YKOL are still unknown. The aim of this systematic review was to assess the efficacy and safety of YKOL in the treatment of threatened miscarriage during the first-trimester pregnancy (TMFP). METHODS: This protocol will be prepared according to the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) statement. The systematic review will include all randomized controlled trials (RCTs) studies published until April 2021. Electronic sources including CNKI, WF, VIP, CBM, MEDLINE(PubMed), Embase, Cochrane Library, and Web of Science will be searched for potentially eligible studies. The international clinical trial registration platform and the Chinese clinical trial registration platform of controlled trials will be searched from their inception until April 1st, 2021. According to the inclusion and exclusion criteria, screening literature, extraction data will be conducted by two researchers independently. Statistical analysis will use RevMan 5.3.5 software. The strength of evidence from the studies will be evaluated with the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) methods. RESULTS: This study will provide evidence for YKOL combined with conventional therapy for TMFP. CONCLUSION: The efficacy and safety of YKOL combined with conventional therapy for TMFP will be assessed. SYSTEMATIC REVIEW REGISTRATION: INPLASY202140105 (https://www.doi.org/10.37766/inplasy2021.4.0105).
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Amenaza de Aborto , Medicamentos Herbarios Chinos , Femenino , Humanos , Embarazo , Amenaza de Aborto/tratamiento farmacológico , Amenaza de Aborto/prevención & control , Medicamentos Herbarios Chinos/uso terapéutico , Metaanálisis como Asunto , Primer Trimestre del Embarazo/efectos de los fármacos , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación , Revisiones Sistemáticas como AsuntoRESUMEN
BACKGROUNDS: Threatened abortion (TA) is the most common complication during early pregnancy affecting 20%-25% pregnancies. A variety of Chinese herbal medicines have shown good protective effects against TA. OBJECTIVE: To analyze the different prescriptions for TA and summarize the medication rules for such treatment. METHODS: Data mining methods including frequency analysis, cluster analysis, factor analysis and association rule learning were used in this study. RESULTS: In total, 171 herbs and 398 formulas were collected. The most frequently used herbs are Dipsaci Radix (Xuduan, accounts for 7.58%). The top three categories were deficiency-tonifying herbs (29.24%), wind-damp dispelling herbs (12.87%) and heat-clearing herbs (9.94%). Eleven factors and 8 clusters with clinical significance for prescription were formed by factor and cluster analyses. CONCLUSIONS: Tonification methods including spleen and kidney nourishment are the main principles for TA treatment and Shoutai Pill can be used as the basic formula for clinical addition or subtraction.
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Amenaza de Aborto , Medicamentos Herbarios Chinos , Amenaza de Aborto/tratamiento farmacológico , China , Minería de Datos , Medicamentos Herbarios Chinos/uso terapéutico , Femenino , Humanos , Medicina Tradicional China , EmbarazoRESUMEN
BACKGROUND: Threatened abortion (TA) is the commonest complication that occurs in early pregnancy, especially in 8-12 gestational weeks when the secretion of estrogen and progesterone shifts from corpus luteum to placental. Conventional therapies are little evidence of their value. In China, traditional Chinese herbal medicine has been widely used for the treatment of TA for a long time. The lack of strong scientific evidences make this a priority area for research. We aim to evaluate the efficacy and safety of traditional Chinese herbal medicine in the treatment of TA, provide medical staffs with more useful information, and provide patients with better advises. METHODS: We will search 8 databases and additional sources, including the Web of Science, PubMed, Cochrane Library, Embase, CBM, Wanfang, VIP, CNKI, and WHO ICTRP, ChiCTR, Clinical Trials, Grey Literature Database, for potentially eligible studies. Literature search, screening and retrieval are performed independently by two researchers. In the event of a dispute, a third party will be consulted to support the judgment. We will use RevmanV.5.3 to perform a fixed-effect meta-analysis for clinical homogeneity study data, and the level of evidence will be assessed using the GRADE method. RESULTS: This systematic review and meta-analysis will put a high-quality synthesis of the efficacy and safety of traditional Chinese herbal medicine in the treatment of TA. CONCLUSION: The conclusion of this systematic review will provide evidence to assess traditional Chinese herbal medicine therapy whether is an efficacy and safe intervention to treat TA. ETHICS AND DISSEMINATION: Since this article does not contain patient personal information, ethical approval is not required. The contract is distributed by a peer-reviewed journal or conference report. REGISTRATION NUMBER: 10.17605/OSF.IO/DG3T8.
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Amenaza de Aborto/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Medicamentos Herbarios Chinos/administración & dosificación , Medicamentos Herbarios Chinos/efectos adversos , Femenino , Humanos , Lactante , Mortalidad Infantil/tendencias , Embarazo , Nacimiento Prematuro/epidemiología , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación , Metaanálisis como AsuntoRESUMEN
Threatened abortion (TA) is a common complication with high incidence in the first trimester of pregnancy, which will end in miscarriage if not treated properly. The Chinese herbs Cuscutae Semen (Tusizi in Chinese) and Herba Taxilli (Sangjisheng in Chinese) first recorded in the ancient classic medical book Shennong Bencao Jing are effective and widely used as an herb pair for the treatment of TA, while the active ingredients and the functional mechanism of Tusizi-Sangjisheng herb pair treating TA are still unknown. In order to exploit the relationship between those two herbs and TA, systems pharmacology analysis was carried out in this study. A total of 75 ingredients of Tusizi-Sangjisheng were collected from Traditional Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP). 12 bioactive compounds were screened, and 153 directly related targets were predicted by systematic models. Besides, Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were used to systematically explore the potential mechanisms of Tusizi-Sangjisheng treating TA. Meanwhile, Compound-Target (C-T), Target-Disease (T-D), and Target-Pathway (T-P) networks were constructed to further quest the underlying functional mechanisms of Tusizi-Sangjisheng. As a result, 31 targets and 3 key pathways were found to be directly related to TA that includes mitogen-activated protein kinases (MAPKs), phosphatidylinositol-3-kinase/protein kinase B (PI3K-Akt), and transforming growth factor-ß (TGF-ß) signaling pathways. The results in this study may provide some valuable clues about the molecular mechanisms of the efficient Chinese herb pair Tusizi-Sangjisheng in the treatment of TA.
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Amenaza de Aborto/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Femenino , Ontología de Genes , Humanos , Medicina Tradicional China/métodos , Embarazo , Transducción de Señal/efectos de los fármacosRESUMEN
To investigate the clinical effect of Gushen Antai pills and progesterone in the treatment of threatened abortion, in order to provide references for early clinical intervention with threatened abortion. The 112 cases of patients with threatened abortion were randomly divided into the control group and the observation group. 56 cases in each group. Patients in the control group was injected with progesterone, the observation group was treated with Gushen Antai pills in addition to the therapy of the control group. Both groups were treated by drugs for two weeks. Their venous bloods (5 mL) were collected before treatment and in 1, 2 weeks after treatment to determine serum levels of ß-HCG, P, E2 and CA125. The differences between the two groups after treatment were compared. The total effective rate of the control group and the observation group were 79% and 91.9% respectively, with a statistically significant difference between the two groups (Pï¼0.05). Two weeks after the treatment, the serum levels of P and E2 in the observation group were significantly higher than before treatment, but the serum CA125 levels decreased significantly after treatment (P<0.05). These indicators showed statistically significant difference compared with that of the control group (P<0.05). After treatment, the serum ß-HCG levels of the two groups were significantly higher than before treatment (P<0.05), but there was no statistically significant difference between the two groups. Gushen Antai pills and progesterone had a better clinical curative effect in treatment threatened abortion, which could significantly raise serum ß-HCG, P and E2, reduce serum CA125 and increase the tocolysis efficiency, and so it was worth promoted in clinic.
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Amenaza de Aborto/tratamiento farmacológico , Antígeno Ca-125/sangre , Dinoprostona/sangre , Medicamentos Herbarios Chinos/administración & dosificación , Hormona de Crecimiento Humana/sangre , Progesterona/sangre , Progestinas/administración & dosificación , Amenaza de Aborto/sangre , Adulto , Quimioterapia Combinada , Femenino , Humanos , Embarazo , Adulto JovenRESUMEN
Largehead Atractylodes Rhizome (LAR) is the most commonly used Chinese herbal medicine for threatened miscarriage. Potential reproductive toxicity of LAR was identified in early pregnancy in animals. Skeletal anomalies including loss of ulna and distal digits, shortening of humerus and radius were observed in higher clinical dose groups. Here, we aimed to study the molecular mechanism of the congenital malformation induced by LAR. In vitro whole mouse embryo culture was used to confirm the embryotoxicity effects of LAR on developing limb buds during early organogenesis. A pregnant mouse model was employed to study the developmental gene expression by quantitative PCR and whole hybridization and apoptosis by terminal deoxynucleotidyl transferase dUTP nick end labeling staining, in the forelimbs and hindlimbs during development in vivo. Severe growth retardation, multiple embryonic malformations and delayed limb bud development were observed. Limb-specific Tbx gene expressions in both developing forelimbs and hindlimbs were significantly decreased. Increased developmental apoptosis in apical ectodermal ridge and mesenchymal mesoderm of the developing limb buds was identified. Overexpressions of Tbx2 and Tbx3 in embryos in vitro rescued LAR-induced abnormal limb development and reduced apoptosis in the developing forelimb buds. In conclusion, LAR affects limb development by suppressing the expression of limb developmental genes and disturbing programmed cell death during limb formation in mice.
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Amenaza de Aborto/tratamiento farmacológico , Atractylodes/química , Medicamentos Herbarios Chinos/efectos adversos , Rizoma/química , Animales , Embrión de Mamíferos/efectos de los fármacos , Embrión de Mamíferos/metabolismo , Femenino , Miembro Anterior/embriología , Miembro Anterior/metabolismo , Hibridación in Situ , Etiquetado Corte-Fin in Situ , Ratones , Reacción en Cadena de la Polimerasa , Embarazo , Proteínas de Dominio T Box/metabolismoRESUMEN
BACKGROUND: Threatened miscarriage occurs in 10% to 15% of all pregnancies. Vaginal spotting or bleeding during early gestation is common, with nearly half of those pregnancies resulting in pregnancy loss. To date, there is no effective preventive treatment for threatened miscarriage. Chinese herbal medicines have been widely used in Asian countries for centuries and have become a popular alternative to Western medicines in recent years. Many studies claim to show that they can prevent miscarriage. However, there has been no systematic evaluation of the effectiveness of Chinese herbal medicines for threatened miscarriage. OBJECTIVES: To review the therapeutic effects of Chinese herbal medicines for the treatment of threatened miscarriage. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2012), Chinese Biomedical Database (1978 to 31 January 2012), China Journal Net (1915 to 31 January 2012), China National Knowledge Infrastructure (1915 to 31 January 2012), WanFang Database (1980 to 31 January 2012), Chinese Clinical Trial Registry (31 January 2012), EMBASE (1980 to 31 January 2012), CINAHL (31 January 2012), PubMed (1980 to 31 January 2012), Wiley InterScience (1966 to 31 January 2012), International Clinical Trials Registry Platform (31 January 2012) and reference lists of retrieved studies. We also contacted organisations, individual experts working in the field, and medicinal herb manufacturers. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials that compared Chinese herbal medicines (alone or combined with other pharmaceuticals) with placebo, no treatment (including bed rest), or other pharmaceuticals as treatments for threatened miscarriage. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed all the studies for inclusion in the review, assessed risk of bias and extracted the data. Data were checked for accuracy. MAIN RESULTS: In total, we included 44 randomised clinical trials with 5100 participants in the review.We did not identify any trials which used placebo or no treatment (including bed rest) as a control.The rate of effectiveness (continuation of pregnancy after 28 weeks of gestation) was not significantly different between the Chinese herbal medicines alone group compared with the group of women receiving Western medicines alone (average risk ratio (RR) 1.23; 95% confidence interval (CI) 0.96 to 1.57; one trial, 60 women).Chinese herbal medicines combined with Western medicines were more effective than Western medicines alone to continue the pregnancy beyond 28 weeks of gestation (average RR 1.28; 95% CI 1.18 to 1.38; five trials, 550 women). AUTHORS' CONCLUSIONS: There was insufficient evidence to assess the effectiveness of Chinese herbal medicines alone for treating threatened miscarriage.A combination of Chinese herbal and Western medicines was more effective than Western medicines alone for treating threatened miscarriage. However, the quality of the included studies was poor. More high quality studies are necessary to further evaluate the effectiveness of Chinese herbal medicines for threatened miscarriage.
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Amenaza de Aborto/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Fitoterapia/métodos , Femenino , Humanos , Embarazo , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
BACKGROUND: Largehead Atractylodes Rhizome (LAR) is the most commonly used Chinese medicine to prevent early pregnancy loss due to threatened miscarriage. However, its safety profile during pregnancy is still not available. Here we aimed to identify the potential adverse effects of LAR on embryo-fetal development as well as prenatal and post-natal growth. METHODS: Pregnant mice, rats and rabbits were orally administered with LAR extracts in various doses (from 1×, 2×, 3× and up to 6× clinical doses) at different gestational periods (implantation, gastrulation, organogenesis, maturation and whole gestation). Maternal effects on weight loss, implantation failure and fetal resorption and perinatal effects on developmental delay, growth restriction and congenital malformations were studied. RESULTS: In mice, with early LAR exposure, a significant decrease in fetal growth parameters and a significant increase in post-implantation loss were identified. With late LAR exposure, significant increases in gestational duration as well as prenatal and post-natal mortality were found. At high clinical doses, congenital skeletal malformations were recorded. In rabbits, fetal resorption, hydrops fetalis and short ear anomaly were observed. No significant adverse effects were found in rats. CONCLUSIONS: Potential reproductive toxicity of LAR in pregnant animals was identified within the clinical dose. Caution should be taken in clinical applications of LAR during pregnancy.
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Amenaza de Aborto/tratamiento farmacológico , Atractylodes/toxicidad , Medicamentos Herbarios Chinos/toxicidad , Fitoterapia/efectos adversos , Anomalías Inducidas por Medicamentos , Aborto Inducido , Animales , Peso Corporal/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Oído/anomalías , Implantación del Embrión/efectos de los fármacos , Desarrollo Embrionario/efectos de los fármacos , Femenino , Retardo del Crecimiento Fetal/inducido químicamente , Reabsorción del Feto/inducido químicamente , Hidropesía Fetal/inducido químicamente , Masculino , Ratones , Ratones Endogámicos ICR , Nivel sin Efectos Adversos Observados , Embarazo , Resultado del Embarazo , Conejos , Ratas , Ratas Sprague-Dawley , Rizoma , Cráneo/anomalíasRESUMEN
OBJECTIVE: To observe the fetus protection effects of Zhixue Baotai Decoction (ZBD) on women of early threatened abortion with dark area surrounding pregnancy sac. METHODS: The 105 patients with early threatened abortion, in whom vaginal bleeding was shown already, were randomly assigned to the treatment group and the control group, who were treated respectively with ZBD and progesterone to protect fetus. The efficacy of treatment was evaluated by dynamic monitoring of serum hormone and B-ultrasonic examination. RESULTS: Among the 54 cases in the treatment group the fetus was protected successfully, showing a fetus protecting rate of 81.5%; while among the 51 cases in the control group, the protection was effective in 22 cases (43.1%), the success rate in the former was better (P<0.01). The dark area was absorbed in 16 out of 19 cases (84.2%) in the treatment group, while in the control group absorption occurred only in 6 out of 17 (35.3%). CONCLUSION: The effect of ZBD is superior to that of progesterone in treating women of early threatened abortion with dark area surrounding pregnancy sac.
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Amenaza de Aborto/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Fitoterapia , Primer Trimestre del Embarazo , Amenaza de Aborto/diagnóstico por imagen , Adulto , Membranas Extraembrionarias/diagnóstico por imagen , Femenino , Humanos , Embarazo , Resultado del Tratamiento , Ultrasonografía , Adulto JovenRESUMEN
This study was carried out to evaluate the clinical efficacy of Xiong-gui-jiao-ai-tang (Kyuki-kyogai-to), a traditional Chinese herbal medicine, in the treatment of threatened abortion in early pregnancy. We enrolled 72 women diagnosed with threatened abortion at Osaka Medical College Hospital and assigned them at random to the following two groups: a group of 36 women who received Xiong-gui-jiao-ai-tang at a dose of 7.5 g/day and another group of 36 women who received human chorionic gonadotropin (hCG)(control group). We found that in the Xiong-gui-jiao-ai-tang group (2.9 + or - 3.5 days), the number of days required before hemostasis was reached in the uterus was significantly shorter than in the control group (10.8 + or - 8.2 days, p < 0.0001). Furthermore, the number of days required for retroplacental hematoma in the vicinity of the gestational sac to disappear was significantly shorter in the Xiong-gui-jiao-ai-tang group (9.9 + or - 7.1 days) than in the control group (23.2 + or - 12.8 days) (p < 0.0001). In retroplacental hematoma size, significant rates of reduction were obtained in both major and minor axis measurements at the 7th day of treatment for the Xiong-gui-jiao-ai-tang group compared to the control group (control vs Xiong-gui-jiao-ai-tang: major axis: 7.5 + or - 3.8% vs 42.3 + or - 10.5%; minor axis: 15.3 + or - 16.8% vs 71.5 + or - 48.2%)(p < 0.0001, each case). The results of this study demonstrated the beneficial effects of Xiong-gui-jiao-ai-tang in stabilizing early pregnancy. Xiong-gui-jiao-ai-tang can be expected to improve unstable early pregnancy with uterine bleeding and to prevent abortion.
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Amenaza de Aborto/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Fitoterapia , Adulto , Femenino , Hematoma/tratamiento farmacológico , Hematoma/patología , Hemostasis/efectos de los fármacos , Humanos , Enfermedades Placentarias/tratamiento farmacológico , Enfermedades Placentarias/patología , Embarazo , Complicaciones del Embarazo/tratamiento farmacológico , Complicaciones del Embarazo/patología , Factores de Tiempo , Resultado del Tratamiento , Adulto JovenRESUMEN
In the report a patient who suffered from threatened abortion was successfully cured with Chinese herbs. After treatment, vaginal bleeding stopped and the aching sensation in the loins and prolapsing sensation in the abdomen disappeared. The gestational ring changed from a crescent moon shape to a normal shape.
Asunto(s)
Amenaza de Aborto/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Fitoterapia , Amenaza de Aborto/diagnóstico por imagen , Adulto , Femenino , Humanos , Embarazo , UltrasonografíaRESUMEN
OBJECTIVE: To observe the effect of Yun'an Granule (YAG) on threatened abortion. METHODS: Five hundred and eighty patients were divided randomly into the treatment group and the control group. The effect of YAG in treating 580 patients was observed by double-blinded method and compared with that treated with progesterone (50 cases) or Shoutai Pill (50 cases) in the control group. And experimental study was conducted also. RESULTS: Clinical results showed that the therapeutic effective rate in YAG (96.9%) was obviously higher than that in the control group (56.0% for progesterone and 86.0% for Shoutai pill), the difference between them was significant (P < 0.05). Experimental results also showed that the YAG had fetus protective effect on the acupuncture or oxytocin induced threatened abortion model in rats, which was better than that of progesterone (P < 0.05). The mean weight of baby rats and placenta delivered by the mother rats which taken YAG were heavier than those which were untreated or treated by progesterone (P < 0.05). In addition, YAG could inhibit the normal or oxytocin stimulated contraction of rat's isolated uterus. CONCLUSION: YAG has good effect in treating threatened abortion and without any adverse effect on fetus.
Asunto(s)
Amenaza de Aborto/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Adulto , Animales , Método Doble Ciego , Femenino , Humanos , Masculino , Embarazo , Progesterona/uso terapéutico , Distribución Aleatoria , Ratas , Ratas WistarAsunto(s)
Medicamentos Herbarios Chinos/uso terapéutico , Infertilidad Femenina/inmunología , Amenaza de Aborto/tratamiento farmacológico , Anticuerpos/sangre , Femenino , Humanos , Técnicas In Vitro , Infertilidad Femenina/diagnóstico , Infertilidad Femenina/tratamiento farmacológico , Masculino , Prednisona/uso terapéutico , Embarazo , Espermatozoides/inmunologíaRESUMEN
41 cases of pregnancy diagnosed as belonging to 4 subtypes of blood stasis, namely, qi stagnant, qi deficient, pernicious cold condensing and heat accumulating, suffering from womb leak, stirred fetus and fetal slip (threatened and habitual abortion) were treated by the method of blood activation and stasis removal in accordance with diagnostic typing. The treatment proved effective in 34 cases, the effective rate reaching 82.9%, with no significant differences either between threatened and habitual abortions or among the groups of cases with different syndromes. The treatment resulted in varying degrees of improvement in blood rheology and the level of serum (human) chorionic gonadotropin (HCG). Follow-up examination of 28 patients who had reacted favorably to the treatment and whose pregnancy had ended in normal deliveries revealed that none of the newborns differed significantly from the normal.