Obstet Gynecol Sci.  2017 Sep;60(5):405-420. 10.5468/ogs.2017.60.5.405.

Use of progesterone supplement therapy for prevention of preterm birth: review of literatures

Affiliations
  • 1Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. drmaxmix.choi@samsung.com

Abstract

Preterm birth (PTB) is one of the most common complications during pregnancy and it primarily accounts for neonatal mortality and numerous morbidities including long-term sequelae including cerebral palsy and developmental disability. The most effective treatment of PTB is prediction and prevention of its risks. Risk factors of PTB include history of PTB, short cervical length (CL), multiple pregnancies, ethnicity, smoking, uterine anomaly and history of curettage or cervical conization. Among these risk factors, history of PTB, and short CL are the most important predictive factors. Progesterone supplement therapy is one of the few proven effective methods to prevent PTB in women with history of spontaneous PTB and in women with short CL. There are 2 types of progesterone therapy currently used for prevention of PTB: weekly intramuscular injection of 17-alpha hydroxyprogesterone caproate and daily administration of natural micronized progesterone vaginal gel, vaginal suppository, or oral capsule. However, the efficacy of progesterone therapy to prevent PTB may vary depending on the administration route, form, dose of progesterone and indications for the treatment. This review aims to summarize the efficacy and safety of progesterone supplement therapy on prevention of PTB according to different indication, type, route, and dose of progesterone, based on the results of recent randomized trials and meta-analysis.

Keyword

Preterm birth; Progesterone; Prevention; 17-alpha-hydroxy-progesterone caproate

MeSH Terms

Cerebral Palsy
Conization
Curettage
Developmental Disabilities
Female
Humans
Infant
Infant Mortality
Injections, Intramuscular
Pregnancy
Pregnancy, Multiple
Premature Birth*
Progesterone*
Risk Factors
Smoke
Smoking
Suppositories
Vaginal Creams, Foams, and Jellies
Progesterone
Smoke
Suppositories
Vaginal Creams, Foams, and Jellies
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