期刊
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
卷 207, 期 5, 页码 -出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.ajog.2012.09.013
关键词
nulliparous; progesterone; progestogen; short cervix
资金
- National Center for Research Resources [NCRR] from NICHD [HD21410, UL1 RR024153, UL1 TR000005, HD27869, HD27915, HD27917, HD34116, HD34208, 5UL1RR025764, HD36801, HD40500, HD40512, HD40544, M01 RR00080, UL1 RR024989]
- NICHD [HD40545, HD40560, HD40485, HD53097, HD53118]
OBJECTIVE: We sought to evaluate whether 17 alpha-hydroxyprogesterone caproate (17-OHP) reduces preterm birth (PTB) in nulliparous women with a midtrimester cervical length (CL) <30 mm. STUDY DESIGN: In this multicenter randomized controlled trial, nulliparous women with a singleton gestation between 16 and 22 3/7 weeks with an endovaginal CL <30 mm (<10th percentile in this population) were randomized to weekly intramuscular 17-OHP (250 mg) or placebo through 36 weeks. The primary outcome was PTB <37 weeks. RESULTS: The frequency of PTB did not differ between the 17-OHP (n = 327) and placebo (n = 330) groups (25.1% vs 24.2%; relative risk, 1.03; 95% confidence interval, 0.79-1.35). There also was no difference in the composite adverse neonatal outcome (7.0% vs 9.1%; relative risk, 0.77; 95% confidence interval, 0.46-1.30). CONCLUSION: Weekly 17-OHP does not reduce the frequency of PTB in nulliparous women with a midtrimester CL <30 mm.
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