Role of 17 α Hydroxy Progesterone Caproate (17OHPC) in the Prevention of Preterm Labor

Abstract

Objective To evaluate the role of 17 a hydroxyprogesterone caproate (17OHPC) in the prevention of preterm labor in high risk asymptomatic patients with a history of preterm delivery. Methods The study included 96 patients with a singleton pregnancy and having a prior preterm birth. They were divided in 2 groups, group I (treatment group) included 46 asymptomatic patients who were given 17OHPC injections starting from 16-20 weeks till 36 weeks and group II (control group) included 50 patients who did not receive any treatment. Results The incidence of preterm delivery was found to be 6.9 %. The median gestational age at delivery was 36 weeks in group I and 33 W5D in controls. 50 % cases in group I and 80 % of controls delivered prematurely in the group with a prior preterm birth between 20-28 weeks. Conclusion In patients who had a prior history of a preterm delivery the recurrence of a preterm birth was less in the treated group as compared to controls. The median gestational age at delivery was significantly higher in 17OHPC treated patients with history of earliest prior preterm delivery at 20-28 weeks.

Effect of 17 Alpha-Hydroxyprogesterone Caproate on Preterm Labor Prevention in Pregnant Women with a History of Preterm Labor

“…According to the study by Nigar et al, the prevalence of preterm delivery was 6.9% in India; the mean gestational age at birth in the 17-OHPC receivers and controls were 36 weeks and 33 weeks plus five days respectively; the gestational age at birth was significantly higher in the case group than in the control group, (23) which is inconsistent with the current study results.…”

Comparison of the frequency of preterm births in patients treated with oral versus intramuscular progesterone with history of previous preterm birth

“…Oral progesterone are easy to take but are less effective because of first pass hepatic metabolism leading to variable plasma levels while intramuscular progesterone carries the risk of swelling and bruising at injection site. 17 There are various studies available which prove role of oral and intramuscular progesterone in the prevention of preterm birth independently or in combination with control groups but there was no comparative data available.…”

“…A study was done in India in which 23 of 46 women treated with 17 α-hydroxyl progesterone (intramuscular) delivered pre-term (50%) when compared to a control group. 17 Various studies also prove role of oral progesterone in reducing the risk of PTB for example PTB occurred in 29 out of 47 (39.2%) using oral progesterone versus a controlled group 44 PTBs out of 74 (59.5%). 18 In order to compare the effectiveness between two routes of progesterone, Maher et al concluded that daily vaginal progesterone administration is associated with lower rates of PTBs as compared to intramuscular weekly progesterone administration after a randomized trial of 502 singleton pregnant women.…”