title: 17-alpha-hydroxyprogesterone caproate versus vaginal progesterone suppository for the prevention of preterm birth in women with a sonographically short cervix: A randomized controlled trial.
abstract: OBJECTIVE
  The aim of this study was to compare 17-alpha-hydroxyprogesterone caproate (17OHP-C) with vaginal progesterone suppository for the prevention of preterm birth in women with a sonographically short cervix and to evaluate the changes of the cervical length (CL) over time.
  
  
  METHODS
  In this prospective randomized controlled trial, eligible patients were asymptomatic pregnant women with a sonographically short cervix. The participants in group 1 (n = 147) received vaginal progesterone suppositories at a dose of 400 mg daily and the women in group 2 (n = 150) received an i.m. dose of 250 mg 17OHP-C once a week. Transvaginal sonography was repeated every 3 weeks until 36 gestational weeks or the occurrence of preterm labor.
  
  
  RESULTS
  A total of 304 singleton pregnant women between 16 and 24 gestational weeks with CL < 25 mm were enrolled in our study. The rates of preterm birth were 10.4% in the progesterone group and 14% in the 17OHP-C group: a difference that was not statistically significant (P = 0.416). Moreover, 264 participants underwent ultrasound examination five times and CL changes were studied for 15 weeks. The results showed that the CL changes over 15 weeks were statistically significant (P < 0.001), but the method of intervention (progesterone/17OHP-C) had no significant effect on CL change (P = 0.64).
  
  
  CONCLUSIONS
  Our findings showed that vaginal progesterone and 17OHP-C had the same effect on the risk of preterm labor in asymptomatic women with a sonographically short cervix. We detected no significant difference between the effect of 17OHP-C and vaginal progesterone on CL changes over time.
authors: Perinatology Division, Obstetrics and Gynecology Department, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Reihaneh
authors: R
authors: Pirjani
authors: School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors: Reza
authors: R
authors: Heidari
authors: Epidemiology and Biostatistics Department, School of Public Health Sciences, Tehran University of Medical Sciences, Tehran, Iran.
authors: Abbas
authors: A
authors: Rahimi-Foroushani
authors: Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.
authors: Seyedehsara
authors: S
authors: Bayesh
authors: Perinatology Division, Obstetrics and Gynecology Department, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Arezoo
authors: A
authors: Esmailzadeh
mesh_terms: D000077713:17 alpha-Hydroxyprogesterone Caproate; D000293:Adolescent; D000328:Adult; D054791:Cervical Length Measurement; D002584:Cervix Uteri / Q000000981:diagnostic imaging / Q000187:drug effects*; D005260:Female; D005865:Gestational Age; D006801:Humans; D006908:Hydroxyprogesterones / Q000627:therapeutic use*; D007752:Obstetric Labor, Premature / Q000188:drug therapy / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced; D047928:Premature Birth / Q000188:drug therapy / Q000517:prevention & control*; D011374:Progesterone / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D013488:Suppositories; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D006908:Hydroxyprogesterones; D013488:Suppositories; D000077713:17 alpha-Hydroxyprogesterone Caproate; D011374:Progesterone
keywords: preterm labor; progesterone; short cervix; vaginal ultrasound