Efficacy of 17 Αlpha Hydroxy Progesterone in Prevention of Preterm Labour in High Risk Patients

Abstract

Objective:  To determine the efficacy of 17 α OH progesterone in prevention of preterm labour in high risk patients.

Study Design:  Randomized control trial.

Place and Duration of Study:  Department of Obs-tetric and gynecology, Fatima Memorial Hospital, Lahore during January 2008 to December 2010.

Patients and Methods:  Two hundreds women fulfill-ing inclusion criteria were recruited in study and were divided into two groups (treated and non-treated). The 17 α OH progesterone injections were started from 20 weeks and on ward on weekly basis until 36 weeks of gestation or delivery whichever occurred first. The pri-mary end point was preterm birth, defined as birth occurring before 37 weeks of gestation. Other outcomes were frequency of episodes of uterine contrac-tions, episodes of preterm labour and response to treat-ment with beta – mimetics.

Results:  The treatment with 17 α OH progesterone helped to prolong pregnancy to full term in 66% as compared to those non treated 11%. There was 4.17 (2.65 – 6.60) time higher RR in non-treated group as compared to treated group for preterm delivery bet-ween 35 – 37 weeks. Similarly the RR was 4.94 (2.61-8.58) and 6.33 (2.95 – 13.60) in non-treated group as compare to treated group of preterm deliveries bet-ween 32 – 35 weeks and < 32 weeks respectively.

Conclusion:  Women with previous preterm births when treated with 17 α OH progesterone showed sig-nificant reduction in spontaneous early preterm deli-very.

Keywords:  17 α OH progesterone, preterm delivery, previous preterm deliveries.