Clinical characteristics of women prescribed 17 alpha-hydroxyprogesterone caproate in the community setting.
OBJECTIVE
The objective of the study was to describe clinical characteristics and pregnancy outcomes of women in a community setting prescribed 17 alpha-hydroxyprogesterone caproate (17P) prophylaxis for prevention of preterm delivery (PTD).


METHODS
A retrospective review was conducted of data collected from patients enrolled for weekly outpatient 17P administration and nursing assessment between April 2004 and January 1, 2006 (n = 1979). Pregnancy history, referral indication, labor/delivery onset (spontaneous or indicated), and gestational duration were identified.


RESULTS
Almost 80% of women prescribed 17P had a prior preterm delivery, although only 711 of the study population (35.9%) met National Institute of Child Health and Human Development (NICHD) study criteria for 17P including initiation of treatment at 16 to 20.9 weeks. Spontaneous PTD occurred in 37.3%; 22.1% delivered less than 35 weeks; and 9.0% less than 32 weeks. More than one quarter of patients (26.9%) discontinued 17P at less than 34 weeks and prior to delivery.


CONCLUSIONS
In community practice, only one third of patients receiving 17P met strict NICHD study criteria. Early initiation and adherence to completion of therapy are clinical issues related to 17P prophylaxis.
Rittenberg
Charles
C
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC 29425, USA. rittenbc@musc.edu
Sullivan
Scott
S
Istwan
Niki
N
Rhea
Debbie
D
Stanziano
Gary
G
Newman
Roger
R
D000077713:17 alpha-Hydroxyprogesterone Caproate; D000328:Adult; D005260:Female; D006801:Humans; D006908:Hydroxyprogesterones / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000517:prevention & control*; D012008:Recurrence; D012111:Residence Characteristics; D012189:Retrospective Studies; D015149:Tocolytic Agents / Q000627:therapeutic use*