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
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Fernand D. Samson
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.
Article note:
Part of this research was presented at the FIGO World Congress 2015 held in Vancouver, Canada from October 4 to 9, 2015 (reference 0099, session name FCS43).
Author’s statement
Conflict of interest: Authors state no conflict of interest.
Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.
Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.
References
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©2018 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review article
- Fetal cardiac tumors: clinical features, management and prognosis
- Original articles – Obstetrics
- Chronic inflammatory lesions of the placenta are associated with an up-regulation of amniotic fluid CXCR3: A marker of allograft rejection
- Gaps in obstetric care processes – we can only improve what is being measured
- Tokophobia (fear of childbirth): prevalence and risk factors
- 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
- The role of ultrasound in the prediction of birth weight discordance in twin pregnancies: are we there yet?
- NLRP genes and their role in preeclampsia and multi-locus imprinting disorders
- Original articles – Fetus
- Diagnostic value of perinatal autopsies: analysis of 486 cases
- Feto-maternal osmotic balance at term. A prospective observational study
- Original articles – Newborn
- Oxygen saturation trends in normal healthy term newborns: normal vaginal delivery vs. elective cesarean section
- Causes of death among full term stillbirths and early neonatal deaths in the Region of Southern Denmark
- Critical congenital heart disease screening with a pulse oximetry in neonates
- DHA reduces oxidative stress following hypoxia-ischemia in newborn piglets: a study of lipid peroxidation products in urine and plasma
- A non-invasive method to rule out transient tachypnea of the newborn (TTN): fetal pulmonary artery acceleration to ejection time ratio
- Letter to the Editor
- Clarification of the methods and statistics in the study “Planned home birth and the association with neonatal hypoxic ischemic encephalopathy”
- Clarification of the methods and statistics in the study “Planned home birth and the association with neonatal hypoxic ischemic encephalopathy”
- Reply to: Planned home birth and the association with neonatal hypoxic ischemic encephalopathy
- Response to the Letter to the Editor, “Risk factors of uterine rupture with a special interest to uterine fundal pressure: methodological issues”
- Re: Utility of routine urine CMV PCR and total serum IgM testing of small for gestational age infants: a single center review
Articles in the same Issue
- Frontmatter
- Review article
- Fetal cardiac tumors: clinical features, management and prognosis
- Original articles – Obstetrics
- Chronic inflammatory lesions of the placenta are associated with an up-regulation of amniotic fluid CXCR3: A marker of allograft rejection
- Gaps in obstetric care processes – we can only improve what is being measured
- Tokophobia (fear of childbirth): prevalence and risk factors
- 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
- The role of ultrasound in the prediction of birth weight discordance in twin pregnancies: are we there yet?
- NLRP genes and their role in preeclampsia and multi-locus imprinting disorders
- Original articles – Fetus
- Diagnostic value of perinatal autopsies: analysis of 486 cases
- Feto-maternal osmotic balance at term. A prospective observational study
- Original articles – Newborn
- Oxygen saturation trends in normal healthy term newborns: normal vaginal delivery vs. elective cesarean section
- Causes of death among full term stillbirths and early neonatal deaths in the Region of Southern Denmark
- Critical congenital heart disease screening with a pulse oximetry in neonates
- DHA reduces oxidative stress following hypoxia-ischemia in newborn piglets: a study of lipid peroxidation products in urine and plasma
- A non-invasive method to rule out transient tachypnea of the newborn (TTN): fetal pulmonary artery acceleration to ejection time ratio
- Letter to the Editor
- Clarification of the methods and statistics in the study “Planned home birth and the association with neonatal hypoxic ischemic encephalopathy”
- Clarification of the methods and statistics in the study “Planned home birth and the association with neonatal hypoxic ischemic encephalopathy”
- Reply to: Planned home birth and the association with neonatal hypoxic ischemic encephalopathy
- Response to the Letter to the Editor, “Risk factors of uterine rupture with a special interest to uterine fundal pressure: methodological issues”
- Re: Utility of routine urine CMV PCR and total serum IgM testing of small for gestational age infants: a single center review
