The role of human chorionic gonadatropin (hCG) in the maintenance of early pregnancy is well known. Recent data suggests that hCG may play a role in the maintenance of the later stages of pregnancy as well, by directly and indirectly promoting uterine quiescence. If hCG acts as an endogenous tocolytic in normal pregnancy, then it may be an ideal candidate for therapy of preterm labor as well. We present compelling in vitro as well as in vivo data, which support the role of hCG in the maintenance of normal uterine quiescence. Additionally, we will present in vivo and in vitro data that confirms the ability of hCG to directly promote relaxation of uterine contractions. This review provides a basis for future study of the use of hCG in clinical obstetrics. Given the limited effectiveness of tocolytic therapies available at the time, hCG may provide a promising pharmacological approach to the pervasive problem of preterm labor in human pregnancy. While further work is needed, initial data strongly support this novel use of hCG in clinical obstetrics.
hCG tocolytic preterm labor treatment, human chorionic gonadotropin uterine quiescence pregnancy, hCG endogenous tocolytic normal pregnancy maintenance, Kurtzman Rao hCG preterm labor tocolysis, hCG uterine relaxation contractions in vitro in vivo, novel tocolytic therapy hCG preterm birth, human chorionic gonadotropin myometrial relaxation, hCG role clinical obstetrics preterm labor prevention, pregnancy maintenance hCG beyond early gestation, tocolytic effectiveness hCG pharmacological approach
PMID 11394205 11394205 DOI 10.1055/s-2001-13912 10.1055/s-2001-13912
Cite this article
Kurtzman, J. T., Wilson, H., & Rao, C. V. (2001). A proposed role for hCG in clinical obstetrics. Seminars in reproductive medicine, 19(1), 63-68. https://doi.org/10.1055/s-2001-13912
Kurtzman JT, Wilson H, Rao CV. A proposed role for hCG in clinical obstetrics. Semin Reprod Med. 2001;19(1):63-68. doi:10.1055/s-2001-13912
Kurtzman, J. T., et al. "A proposed role for hCG in clinical obstetrics." Seminars in reproductive medicine, vol. 19, no. 1, 2001, pp. 63-68.
Previous studies have demonstrated that human myometrium contains receptors for human chorionic gonadotropin (hCG) and that hCG can inhibit myometrial contractions in vitro. To use for the first time hCG as a tocolytic agent in the treatment of preterm labor. The study group included 100 women with preterm labor; 50 were assigned to receive HCC and 50 placebo. Assignment was made with stratification according to four categories of gestational age between 20–35 weeks. One half of the surviving infants were followed-up at 18 months. The protocol of the dosage consisted of one single dose of hCG 5,000 IV and 10,000 units of hCG in 500 dextrose as a drip of 20 drops per minute. The mean length of time from randomization to delivery differs significantly 28.8 days for the hCG group and 15 days for the placebo treatment group (highly statistically significant, P <0.001). There was statistically significant difference (P <0.05) between the two groups regarding the induction of delivery before 37 weeks and the proportion of infants weighing less than 2,500 g. Human chorionic gonadotropin treatment was associated with an improvement score on the Bayley psychomotor development index. Human chorionic gonadotropin exhibits potent tocolysis with no fetal side effects. This preliminary study suggests that HCG may be a candidate for tocolytic therapy of preterm labor.
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