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Progesterone and Daily Home Uterine Activity Monitoring Prevent Recurrent Preterm Delivery Equally Well: Presented at ACOG
By Maggie Schwarz
WASHINGTON, D.C. -- May 11, 2006 -- The two interventions known to prevent preterm delivery work equally well, according to findings presented here at the 54th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists (ACOG).
Charles Rittenberg, MD, fellow in maternal-fetal medicine, department of obstetrics and gynecology, Medical University of South Carolina, Charleston, South Carolina, reported the findings of his study, which compared the efficacy of home uterine activity monitoring or progesterone injections for prevention of preterm delivery.
Risks factors for preterm delivery include multiple gestations, previous preterm delivery and cervical incompetence. The two methods commonly used to prevent preterm labor are home uterine activity monitoring and 17-alpha hydroxyprogesterone caproate (17P) injections administered for 16 to 36 weeks.
For their study, Dr. Rittenberg and colleagues enrolled women with history of preterm delivery and who were receiving outpatient services for home uterine activity monitoring with prenatal nursing assessment or weekly nursing visits with 17P injection. Patients who were receiving 17P were matched 1:1 to patients receiving home uterine activity monitoring by maternal age, marital status, tobacco use, number of preterm deliveries and cerclage of the cervix.
The primary study outcome was incidence of preterm delivery and data were compared for 305 matched pairs.
Results show that the incidence of preterm rupture of membranes (8.5% vs. 7.9%, not significant) and preterm labor with preterm delivery at less than 32, 35 and 37 weeks gestation were similar between groups.
The incidence of hospitalization for suspected preterm labor, use of tocolysis and diagnosis of preterm labor with or without preterm delivery was decreased in patients receiving 17P.
Dr. Rittenberg stressed that the rate of preterm births is on the rise in the U.S. despite efforts and research aimed to lower it.
In his presentation on May 9th, Dr. Rittenberg stated, "The 2 methods for reducing preterm delivery work equally well. The next question to answer is whether using both modalities improves outcome even more. That will be our next study."
[Presentation title: The Incidence of Preterm Labor in Women With Previous Preterm Delivery Treated With 17P-Hydroxyprogesterone Caproate Compared With Home Uterine Activity Monitoring. Abstract p. 37S]
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