Cervical length changes during preterm cervical ripening: effects of 17-alpha-hydroxyprogesterone caproate.
OBJECTIVE
The purpose of this study was to evaluate whether 17-alpha-hydroxyprogesterone caproate (17P) treatment affect changes in cervical length.


METHODS
Women with singleton pregnancy, between 25 and 33 + 6 weeks of gestation, who were hospitalized for preterm labor were included. Patients with rupture of membranes and/or signs of chorioamnionitis were excluded. Sixty undelivered patients were allocated randomly to either observation or to receive 341 mg of 17P intramuscularly, twice each week until gestational week 36. Cervical length was measured by transvaginal ultrasound scanning at discharge and at day 7 and 21 after discharge. Statistical comparisons were done with analysis of variance and chi-square test.


RESULTS
Shortening of the cervix in the observation group (30 cases) was higher than in the 17P group (30 cases) both at day 7 (2.37 +/- 2.0 mm vs 0.83 +/- 1.74 mm; P = .002) and day 21 (4.60 +/- 2.73 mm vs 2.40 +/- 2.46 mm; P = .002). Treatment with 17P was associated with both a reduction in the risk of cervical shortening of > or = 4 mm (odds ratio, 0.18; 95% CI, 0.04-0.66) and in the risk of preterm delivery (odds ratio, 0.15; 95% CI, 0.04-0.58).


CONCLUSIONS
Undelivered patients after preterm labor undergo progressive shortening of the cervix, which is attenuated by 17P treatment.
Facchinetti
Fabio
F
Unit of Obstetrics, Mother-Infant Department, University of Modena and Reggio Emilia, Reggio Emilia, Italy. Facchi@unimore.it
Paganelli
Simone
S
Comitini
Giuseppina
G
Dante
Giulia
G
Volpe
Annibale
A
D019326:17-alpha-Hydroxyprogesterone / Q000494:pharmacology* / Q000627:therapeutic use; D002208:Caproates / Q000494:pharmacology*; D020070:Cervical Ripening / Q000187:drug effects*; D002584:Cervix Uteri / Q000000981:diagnostic imaging / Q000187:drug effects*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D011247:Pregnancy; D011446:Prospective Studies; D014463:Ultrasonography
D002208:Caproates; D012739:Gonadal Steroid Hormones; D019326:17-alpha-Hydroxyprogesterone