Role of 17 α Hydroxy Progesterone Caproate (17OHPC) in the Prevention of Preterm Labor (original) (raw)
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Journal of Current Medical Research and Practice, 2020
Preterm birth is delivery before 37 weeks of gestation it remains a global challenge with an incidence of 11.1% (1). Progestogens are the only medications that their use showed reduction in incidence of preterm birth (2.3) they are used in asymptomatic women who are at increased risk of preterm birth based on their history and ultrasound finding of short cervical length, their use is supported and guideline recommendation published by Society for Maternal Fetal Medicine publications committee 2012 ,American collage of Obstetricians and gynecology committee on practice bulletin 2012 and European Association of PerinatalMedicine.
Single dose 17 alpha-hydroxyprogesterone caproate in preterm labor: a randomized trial
Archives of Gynecology and Obstetrics, 2012
Objective To evaluate the effect of a single 250-mg dose of 17 alpha-hydroxyprogesterone caproate (17-OHPC) intramuscularly as adjunct to nifedipine tocolysis in preterm labor. Method Women diagnosed with threatened preterm labor between 22 and 35 weeks’ gestation scheduled to receive nifedipine tocolysis and prophylactic antenatal corticosteroid were randomized to a single intramuscular injection of 250 mg of 17-OHPC or placebo saline in a double-blind fashion. Nifedipine tocolysis and corticosteroids were administered to all participants. Further management was otherwise carried out according to providers’ discretion. Main outcome measures are delivery within 48 h and 7 days. Results Data were analyzed for the 56 participants randomized to 17-OHPC and 56 randomized to placebo. Delivery rates within 48 h were 11/54 (20.4%) versus 15/56 (26.8%) RR 0.76 (95% CI 0.38–1.51) and within 7 days were 13/52 (25.0%) versus 19/54 (35.2%) RR 0.71 (95% CI 0.39–1.29) for 17-OHPC and placebo groups, respectively, and were similar. Recruitment to delivery interval, gestation at delivery, delivery rate before 34 weeks’ and 37 weeks’ gestation, and neonatal outcomes were also similar. Conclusion The results indicated that adjunctive single-dose 17-OHPC in combination with nifedipine tocolysis for threatened preterm labor did not delay delivery.
Efficacy of 17 Αlpha Hydroxy Progesterone in Prevention of Preterm Labour in High Risk Patients
Annals of King Edward Medical University, 2012
Objective: To determine the efficacy of 17 α OH progesterone in prevention of preterm labour in high risk patients. Study Design: Randomized control trial. Place and Duration of Study: Department of Obs-tetric and gynecology, Fatima Memorial Hospital, Lahore during January 2008 to December 2010. Patients and Methods: Two hundreds women fulfill-ing inclusion criteria were recruited in study and were divided into two groups (treated and non-treated). The 17 α OH progesterone injections were started from 20 weeks and on ward on weekly basis until 36 weeks of gestation or delivery whichever occurred first. The pri-mary end point was preterm birth, defined as birth occurring before 37 weeks of gestation. Other out comes were frequency of episodes of uterine contrac-tions, episodes of preterm labour and response to treat-ment with beta – mimetics. Results: The treatment with 17 α OH progesterone helped to prolong pregnancy to full term in 66% as compared to those non treated 11%. ...
Journal of Maternal-Fetal and Neonatal Medicine, 2010
Evaluation of an outpatient 17 α-hydroxyprogesterone caproate (17P) administration programme. A retrospective analysis of data collected from patients with a history of preterm birth (PTB) and current singleton gestation enrolled between 16.0 and 20.9 weeks' gestational age (GA) for weekly outpatient 17P administration and nursing assessment between 7/2004 and 12/2007 was conducted (n=3139). The population was mostly white (50.3%), 18-35 years old (77.7%), and married (67.0%). Median GA at 17P initiation and stop was 17.4 (16.0, 20.9) weeks and 35.1 (18.6, 37.4) weeks. Mean injections per patient were 16.5±4.9, at an interval of 7.2 days. Median GA at delivery was 37.3 (18.6, 44.0) weeks. Rate of recurrent spontaneous PTB was 29.8%, with 15.5% and 7.0% with PTB at <35 and <32 weeks. This represents the largest cohort reported to date of patients prescribed 17P therapy in clinical practice to prevent recurrent spontaneous PTB.
Progesterone for prevention of recurrent preterm birth: Impact of gestational age at prior delivery
American Journal of Obstetrics and Gynecology, 2004
Objective: Preterm birth occurs in 1 of 8 pregnancies and may result in significant morbidity and mortality. 17-alpha hydroxyprogesterone caproate (17-OHP caproate) has been found to be efficacious in reducing the risk of subsequent preterm delivery in women who have had a previous spontaneous preterm birth (sPTB). This analysis was undertaken to evaluate if 17-OHP caproate therapy works preferentially depending on the gestational age at previous spontaneous delivery. We hypothesized that treatment with 17-OHP caproate is more effective in prolonging pregnancy depending on the gestational age of the earliest previous preterm birth (20-27.9, 28-33.9 vs 34-36.9 weeks).
Prevention of Preterm Birth in Triplets Using 17 Alpha-Hydroxyprogesterone Caproate
Obstetrics & Gynecology, 2009
Objective-To assess whether 17 alpha-hydroxyprogesterone caproate reduces the rate of preterm birth in women carrying triplets. Methods-We performed this randomized, double blinded, placebo controlled trial in 14 centers. Healthy women with triplets were randomized to weekly intramuscular injections of either 250 mg of 17 alpha-hydroxyprogesterone caproate or matching placebo, starting at 16-20 weeks and ending at delivery or 35 weeks of gestation. The primary study outcome was delivery or fetal loss prior to 35 weeks. Results-One hundred thirty-four women were randomized, 71 to 17 alpha-hydroxyprogesterone caproate and 63 to placebo; none were lost to followup. Baseline demographic data were similar in the two groups. The proportion of women experiencing the primary outcome (a composite of delivery or fetal loss prior to 35 0/7 weeks) was similar in the two treatment groups : 83% of pregnancies in the 17 alpha-hydroxyprogesterone caproate group and 84% in the placebo group, relative risk (RR) 1.0, 95% confidence interval (CI) 0.9 to1.1. The lack of benefit of 17 alpha-hydroxyprogesterone caproate was evident regardless of the conception method or whether a gestational age cut off for delivery was set at 32 or 28 weeks. Conclusion-Treatment with 17 alpha-hydroxyprogesterone caproate did not reduce the rate of preterm birth in women with triplet gestation.
American journal of obstetrics and gynecology, 2015
Prematurity is the leading cause of neonatal morbidity and mortality amongst non-anomalous neonates in the United States. Intramuscular 17-alpha hydroxyprogesterone caproate (17OHP-C) injections reduce the risk of recurrent prematurity by approximately one third. Unfortunately, prophylactic 17OHP-C is not always effective, and one-third of high-risk women will have a recurrent PTB despite 17OHP-C therapy. The reasons for this variability in response are unknown. Previous investigators have examined the influence of a variety of factors on 17OHP-C response, but have analyzed data used a fixed outcome of 'term' delivery to define progesterone response. We hypothesized that the demographics, history, and pregnancy course among women who deliver at a similar gestational age with 17-alpha hydroxyprogesterone caproate (17OHP-C) for recurrent spontaneous preterm birth (SPTB) prevention differs when compared to those women who deliver later with 17OHP-C, and that these associations ...
Progesterone supplementation for prevention of preterm labor: A randomized controlled trial
Middle East Fertility Society Journal, 2010
Objective: To evaluate the efficacy of intramuscular progesterone in prevention of preterm labor in high risk cases. Design: Randomized controlled trial. Setting: Ain Shams Maternity hospital. Materials and methods: Singleton pregnant women in their second trimester with a history of previous preterm labor were divided into two groups: progesterone group: received 17-a-hydroxy progesterone caproate (Cidolut depot) one dose of 250 mg IM once weekly until 36 weeks and placebo group: received standard dose of placebo IM per week. Follow up till delivery. Results: The mean gestational age was 37.4 ± 1.5 in progesterone group vs. 34.7 ± 2.4 in placebo group (P < 0.05). In the progesterone group 8 of 25 women delivered before completion of 37 weeks of gestation (32%) and 17 women delivered full term (68%). In placebo group, 13 of 25 women delivered before completion of 37 weeks of gestation (52%) and 12 women delivered full term (48%). Conclusion: Our findings support 17-a-hydroxy progesterone as a successful drug in the prevention and decreasing the rate of recurrent preterm labor.