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- Title
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.
- Authors
Samson, Fernand D.; Merriman, Amanda L.; Tate, Danielle L.; Apostolakis-Kyrus, Katherine; Gomez, Luis M.
- 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. 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). 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. 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
COMBINED modality therapy; DISEASE complications; DRUG synergism; GESTATIONAL age; PREMATURE infants; LONGITUDINAL method; MATERNAL health services; SECOND trimester of pregnancy; PROGESTERONE; TREATMENT effectiveness; CONTROL groups; RETROSPECTIVE studies; CAPROATES; CERVICAL cerclage
- Publication
Journal of Perinatal Medicine, 2018, Vol 46, Issue 2, p155
- ISSN
0300-5577
- Publication type
Article
- DOI
10.1515/jpm-2017-0074