PROPHYLACTIC USE OF 17OH PROGESTERONE FOR PREVENTION OF PRETERM LABOUR IS EFFECTIVE

Abstract

Objective: To show efficacy of 17OH progesterone in prevention of preterm labor in comparison with frequent monitoring.

Study Design: Randomized clinical trial. Place and Duration of Study: Department of Obstetrics and Gynecology, Combined Military Hospital Attock, from May 2011 to Dec 2011.

Methodology: Total 100 patients of high risk preterm delivery were selected from outpatient department. Patients were divided into two groups, fifty patients in group A, who were managed by frequent monitoring only and no treatment used for them. Fifty patients in group B, were given injection Proluton depot prophylactically (17OH progesterone) on weekly basis from 16 weeks of pregnancy till 37 weeks. Women included in study were educated about signs and symptoms of preterm labor, and about the importance of early diagnosis and treatment. The women were followed according to their group assignments until either preterm delivery or 37 weeks.

Results: Out of 50 patients, 41 (82%) deliveries in group A were between 32 -36 weeks of pregnancy, there was no delivery at or >37 weeks as compared to group B, in which 14 (28%) deliveries were beyond 37 weeks of gestation. Only 4 (8%) patients in group B, were delivered before 31 weeks of pregnancy as compared to group A in which this number was 9 (18%) (p-value <0.001). Regarding neonatal outcomes, respiratory distress syndrome was seen in 30 (60%) babies in group A and in 18 (36%) babies in group B (p-value 0.016). Neonatal death (NND) occurred in 5 (10%) newborns in group A and only 2 (4.0%) in group B. However this difference in NND was not statistically significant (p-value 0.24). APGAR score was poor in 14 (28%) babies in group-B as compared to group A, in which poor APGAR score was seen in 30 (60%) babies (p-value <0.001).

Conclusion: Prophylactic use of 17OH progesterone in prevention of preterm labor is effective. It improves neonatal outcome and reduces the incidence of preterm deliveries.