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Adjuvant administration of 17-α-hydroxy-progesterone caproate in women with three or more second trimester pregnancy losses undergoing cervical cerclage is no more effective than cerclage alone.
- Source :
-
Journal of perinatal medicine [J Perinat Med] 2018 Feb 23; Vol. 46 (2), pp. 155-161. - Publication Year :
- 2018
-
Abstract
- Objective: To investigate the role of adjuvant 17-α-hydroxy-progesterone caproate (17OHP-C) in reducing the risk of preterm delivery <34 weeks and adverse perinatal outcomes in women with ≥3 second trimester pregnancy losses attributed to cervical insufficiency undergoing prophylactic cerclage.<br />Material and Methods: Retrospective cohort study of women with prophylactic cerclage placed between 2006 and 2014 divided into a cohort of (i) those receiving adjuvant 17OHP-C (n=43), and (ii) controls with cerclage alone (n=59).<br />Results: Demographic characteristics were comparable in both groups. There was no significant difference in gestational age at delivery between the cerclage-17OHP-C group (33.4±5.6 weeks) and the cerclage-alone group (34.4±4.6 weeks); P=0.33. We noted a non-significant increase for deliveries <34 weeks in the cerclage-17OHP-C group (44.2%) compared to controls (28.8%) which remained non-significant after adjusting for confounders; P=0.46. There was no statistically significant difference in the rate of delivery <37, 32, 28 and 24 weeks. Adverse neonatal outcomes were comparable in both groups (cerclage-17OHP-C 48.8% vs. cerclage-alone 39%); P=0.43.<br />Conclusion: Intramuscular 17OHP-C in combination with prophylactic cerclage in women with cervical insufficiency and ≥3 second trimester pregnancy losses had no synergistic effect in reducing the rate of recurrent preterm birth or improving perinatal outcomes.
- Subjects :
- 17 alpha-Hydroxyprogesterone Caproate
Adult
Cohort Studies
Estrogen Antagonists administration & dosage
Female
Humans
Injections, Intramuscular
Pregnancy
Pregnancy Outcome
Pregnancy Trimester, Second drug effects
Pregnancy Trimester, Second physiology
Retrospective Studies
United States epidemiology
Uterine Cervical Incompetence physiopathology
Cerclage, Cervical methods
Hydroxyprogesterones administration & dosage
Premature Birth epidemiology
Premature Birth etiology
Premature Birth prevention & control
Uterine Cervical Incompetence therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1619-3997
- Volume :
- 46
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of perinatal medicine
- Publication Type :
- Academic Journal
- Accession number :
- 28753545
- Full Text :
- https://doi.org/10.1515/jpm-2017-0074