Suppression of threatened premature labor by administration of cortisol and 17 alpha-hydroxyprogesterone caproate: a comparison with ritodrine.
A shift in progesterone-to-estradiol balance to estradiol dominance is assumed to be a prerequisite for regular uterine contractions. To antagonize this effect in premature labor 24 consecutive women were treated with intravenous cortisol for 3 days and with weekly intramuscular injections of 17 alpha-hydroxyprogesterone caproate (17 OHP-C). Twenty-four similar patients treated with ritodrine served as a reference group. The delivery was postponed by at least 1 week in 21 patients (87.5%) in the steroid treatment group and in 18 patients (75%) in the ritodrine group. The premature labor lasted for 5.1 +/- 0.4 hours (mean +/- SEM) with steroid therapy and for 2.2 +/- 0.3 hours with ritodrine. In singleton pregnancies the gestational length and birth weight of the newborn infants were greater in the steroid treatment group (N = 23, 39.1 +/- 0.3 weeks, 3,460 +/- 119 gm) than in the ritodrine group (N = 24, 37.7 +/- 0.4 weeks, 3,106 +/- 118 gm). Steroid treatment suppressed serum estradiol concentrations (maximally by 60%) and, to a lesser extent, testosterone, estriol, and progresterone levels (maximally by 30%).
D000077713:17 alpha-Hydroxyprogesterone Caproate; D004958:Estradiol / Q000097:blood; D004964:Estriol / Q000097:blood; D004965:Estrogen Antagonists / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use*; D006908:Hydroxyprogesterones / Q000627:therapeutic use*; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D011247:Pregnancy; D011374:Progesterone / Q000097:blood; D011412:Propanolamines / Q000627:therapeutic use*; D012312:Ritodrine / Q000627:therapeutic use*; D013739:Testosterone / Q000097:blood
D004965:Estrogen Antagonists; D006908:Hydroxyprogesterones; D011412:Propanolamines; D000077713:17 alpha-Hydroxyprogesterone Caproate; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol; D004964:Estriol; D012312:Ritodrine; D006854:Hydrocortisone