Role of 17-Hydroxyprogesterone Caproate as an Adjuvant Therapy in Women With Cervical Cerclage for Prevention of Preterm Delivery: A Retrospective Matched Controlled Study

Nishat Fatema, Mohamed Mohamed Elawdy, Mahin Rahman, Maha Al-Khaduri

Abstract


Background: We aimed to evaluate the role of 17-hydroxyprogesterone caproate (17-OHP) as an adjuvant therapy with cervical cerclage for prevention of preterm delivery.

Methods: We conducted a retrospective case-control study from July 2010 to December 2014 on patients who received 17-OHP with cervical cerclage (group 1). This group was compared to matched control patients who had cervical cerclage only (group 2). The maternal and fetal outcomes were compared between the two groups. All data were collected using SPSS Mac version 23.

Results: A total of 122 singleton pregnant women with cervical cerclage were observed; among them, 64 patients used 17-OHP with cerclage, and 58 patients received cerclage only. Our analysis demonstrated that there was no significant difference in the outcome between the two groups. Characteristics compared in both groups such as cervical length, miscarriage rates, gestational age at time of delivery, mode of delivery, and other variables did not meet any statistical significance. Preterm outcome at 37, above 37, and below 37 weeks, was similar in both groups. In fetal outcome, the only statistical difference was the Apgar score of neonates at 1 min that was better in group 1 (P = 0.04), but at 5 min, the Apgar score did not show any difference (P = 0.7).

Conclusions: In our study, we found no additional benefits of adjuvant 17-OHP on maternal, fetal outcome, or preterm delivery outcome in comparison to cervical cerclage alone. More prospective randomized studies are recommended to further investigate this matter.




J Clin Gynecol Obstet. 2017;6(1):12-16
doi: https://doi.org/10.14740/jcgo422w

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Keywords


Preterm labor; Cervical cerclage; 17-alpha-hydroxyprogesterone; Adjuvant; Prematurity

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