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Re: OB: progesteroneFrom: Malcolm Griffiths (Malcolm@MGRIFF22.demon.co.uk)Sat Jun 27 09:53:25 1998
In message <199806250340.NAA19091@ariel.ucs.unimelb.EDU.AU>, Peter Wein <p.wein@obsgyn-mercy.unimelb.EDU.AU> writes >At 04:23 PM 24/06/98 -0500, you wrote: >>In message <c=US%a=_%p=Americal_Medical%l=AMM1EXCH-980623143514Z- >>17122@amm2mg1.americanmed.com>, Geffrey Klein <GK6972@americanmed.com> >>writes >>>Am I missing something? >>> >>Yes - you should be more forthright! >> >>There is no proven benefit of prog supplementation at all outside of >>assisted conception. Any use otherwise is at best placeboa nd at worst >>quack! >> >Malcolm: no proven benefit is an exaggeration - see below. > >17alpha-hydroxyprogesterone caproate in pregnancy > Reviewer(s) : Prendiville WJ The summary you sent mentions possible benefits in terms of avoiding preterm birth - requiring multiple injections. The discussion was about the use of prog in first trimester use to prevent miscarriage. Even in this review the beneficial effects show 95% CI for OR which either reach unity (1.0) or almost do (0.95). In the context that there are multiple endpoints to address in such studies, many would argue that a greater degtree of statistical significance is required. (Test 20 hypoteses on one dataset and it is likely that 5% [ie, one] will reach stat sign at the 5% level). I recall at least two metanalyses addressing prog for rec miscarriage about three years ago. Both showed no benefit *against recurrent misscarriage*! Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt Obstetrician & Gynaecologist Luton & Dunstable Hosp.,UK. Tel: 01582-497459 (office) Fax: 01582-497376 01525-222849 (home) email: Malcolm@mgriff22.demon.co.uk http://www.obgyn.net/board/griffith.htm "CLINICAL FREEDOM IS THE LAST REFUGE OF THE CLINICALLY INCOMPETENT!" (Someone [1997])
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