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17-α-Hydroxyprogesterone May Reduce Preterm Birth Risk

In randomized trial, 16 percent of hormone-treated women had a preterm delivery compared with 57 percent of controls

TUESDAY, May 8 (HealthDay News) -- Women at risk of preterm delivery are less likely to have cervical shortening and preterm delivery if they are treated with 17-α-hydroxyprogesterone caproate, according to the results of a randomized trial in the May issue of the American Journal of Obstetrics & Gynecology.

Fabio Facchinetti, M.D., of the University of Modena in Italy, and colleagues placed 60 pregnant women (25 to 33 weeks' gestation), admitted to hospital for threatened preterm labor, into two groups. One group received 17-α-hydroxyprogesterone caproate (341 mg) every four days until gestational week 36; the other did not. The investigators used transvaginal ultrasound scanning to assess changes in cervical length in both groups one and three weeks after study enrollment.

Subjects in the treatment group experienced less cervical shortening than did subjects in the observation group, both at day seven (0.83 mm versus 2.37 mm) and day 21 (2.40 mm versus 4.60 mm). They also experienced fewer preterm deliveries prior to week 37 (16 percent) than did patients in the observation group (57 percent), and a correspondingly higher average birth weight (3,103 gm versus 2,809 gm). Odds ratios in the treatment group for cervical shortening greater than 4 mm or of preterm delivery were 0.18 and 0.15, respectively.

"At this time, it is prudent to suggest that the use of high-dose 17-α-hydroxyprogesterone caproate to treat symptomatic women should be restricted to randomized trials," writes the author of an accompanying editorial.

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