Amongst this group of twin gestations weekly 17HP injections did not reduce the incidence of preterm birth or the complications associated with prematurity.

BACKGROUND Inflammatory cytokines such as tumor necrosis factor-α (TNF-α) may be an important link between placental ischemia and hypertension in preeclampsia. We examined the effect of 17-hydroxyprogesterone caproate (17-OHP) on TNF-α-stimulated endothelin (ET) production and hypertension during pregnancy. METHODS TNF-α-stimulated ET was examined from endothelial cells cultured in the presence and absence of progesterone. Blood pressure and tissue ET-1 were measured in the following groups of pregnant rats: controls, 17-OHP (3.32 mg/kg), TNF-α treated (50 ng/day), TNF-α treated+17-OHP. RESULTS Progesterone abolished TNF-α-stimulated ET-1 from endothelial cells. TNF-α-induced hypertension was associated with significant increases in renal and placental ET-1. Administration of 17-OHP attenuated TNF-α-induced hypertension and decreased renal ET-1. CONCLUSION Progesterone directly abolished TNF-α-stimulated ET-1 and attenuated TNF-α-induced hypertension, possibly via suppression of the renal ET-1 system. These data suggest that treatment with progesterone of hypertension associated with elevated cytokines during pregnancy may be worthy of further consideration.

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Objective-Reduction in uteroplacental perfusion (RUPP) in pregnant rats is associated with hypertension, elevated cytokines, and activation of the endothelin (ET-1) system. Our objective was to determine if the anti-inflammatory properties of 17-alpha hydroxyprogesterone caproate (17OHP) reduces cytokine stimulated vasoactive pathways that are associated with hypertension in response to placental ischemia.Study Design-MAP, TNF-α, IL-6, and renal ET-1 were measured in the following: pregnant controls, pregnant controls + 17OHP (6.6mg/kg), RUPP rats, RUPP rats + 17OHP.Results-MAP increased 29mmHg in RUPP rats compared to pregnant controls (P<0.001); while in RUPP+17OHP rats MAP increased only 19mmHg (P<0.05). TNF-α and IL-6 increased 2-3 fold, respectively, in response to placental ischemia but was normalized in RUPPs treated with 17 OHP. ET-1 increased 3 fold in RUPP rats but was markedly less in RUPP+17 OHP rats. Conclusion-17OHPblunts hypertension associated with RUPP possibly via suppression of cytokine stimulated ET-1 activation.