Failure of 17-hydroxyprogesterone to reduce neonatal morbidity or prolong triplet pregnancy: a double-blind, randomized clinical trial.
OBJECTIVE
To test whether 17 alpha-hydroxyprogesterone caproate (17P) will reduce neonatal morbidity by increasing gestational age at delivery in triplet pregnancies.


METHODS
Double-blind, randomized clinical trial. Mothers carrying trichorionic-triamniotic triplets were randomly assigned (in a 2:1 ratio) to weekly injections of 250 mg of 17P or placebo, starting at 16-22 weeks and continued until 34 weeks. Primary outcome was composite neonatal morbidity.


RESULTS
Fifty-six women were randomized to 17P and 25 to placebo. Composite neonatal morbidity occurred with similar frequency in the 17P and placebo groups (38% vs 41%, respectively; P = .71). Mean gestational age at delivery was not affected by 17P (31.9 vs 31.8 weeks; P = .36). There were 13 midtrimester fetal losses with 17P vs none with placebo (P < .02).


CONCLUSIONS
In triplet pregnancy, prophylactic treatment with 17P did not reduce neonatal morbidity or prolong gestation but was associated with increased midtrimester fetal loss.
Combs
C Andrew
CA
Obstetrix Medical Group, Sunrise, FL, USA.
Garite
Thomas
T
Maurel
Kimberly
K
Das
Anita
A
Porto
Manuel
M
D019326:17-alpha-Hydroxyprogesterone / Q000627:therapeutic use*; D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D004311:Double-Blind Method; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D018566:Pregnancy, High-Risk; D011272:Pregnancy, Multiple; D047928:Premature Birth / Q000517:prevention & control*; D014310:Triplets
D019326:17-alpha-Hydroxyprogesterone