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17-Alpha-Hydroxyprogesterone Caproate Versus Vaginal Progesterone Suppository for the Prevention of Preterm Birth in Women With a Sonographically Short Cervix: A Randomized Controlled Trial Publisher Pubmed



Pirjani R1 ; Heidari R2 ; Rahimiforoushani A3 ; Bayesh S4 ; Esmailzadeh A1
Authors
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Authors Affiliations
  1. 1. Perinatology Division, Obstetrics and Gynecology Department, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Epidemiology and Biostatistics Department, School of Public Health Sciences, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran

Source: Journal of Obstetrics and Gynaecology Research Published:2017


Abstract

Aim: The aim of this study was to compare 17-alpha-hydroxyprogesterone caproate (17OHP-C) with vaginal progesterone suppository for the prevention of preterm birth in women with a sonographically short cervix and to evaluate the changes of the cervical length (CL) over time. Methods: In this prospective randomized controlled trial, eligible patients were asymptomatic pregnant women with a sonographically short cervix. The participants in group 1 (n = 147) received vaginal progesterone suppositories at a dose of 400 mg daily and the women in group 2 (n = 150) received an i.m. dose of 250 mg 17OHP-C once a week. Transvaginal sonography was repeated every 3 weeks until 36 gestational weeks or the occurrence of preterm labor. Results: A total of 304 singleton pregnant women between 16 and 24 gestational weeks with CL < 25 mm were enrolled in our study. The rates of preterm birth were 10.4% in the progesterone group and 14% in the 17OHP-C group: a difference that was not statistically significant (P = 0.416). Moreover, 264 participants underwent ultrasound examination five times and CL changes were studied for 15 weeks. The results showed that the CL changes over 15 weeks were statistically significant (P < 0.001), but the method of intervention (progesterone/17OHP-C) had no significant effect on CL change (P = 0.64). Conclusion: Our findings showed that vaginal progesterone and 17OHP-C had the same effect on the risk of preterm labor in asymptomatic women with a sonographically short cervix. We detected no significant difference between the effect of 17OHP-C and vaginal progesterone on CL changes over time. © 2016 Japan Society of Obstetrics and Gynecology
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