461: Common tagSNPs on progesterone receptor (PGR) gene are marginally associated with pre-term delivery in women receiving 17 alpha-hydroxyprogesterone caproate (17-P) treatment

Objective. To determine if gestational age of prior preterm delivery influences a woman's receipt of 17-hydroxyprogesterone caproate (17-OHP-C).Methods. Retrospective cohort of women eligible for 17-OHP-C at Duke Obstetrics Clinic were identified by medical record review. Sociodemographic and clinical characteristics were abstracted.Results. Of 104 eligible subjects, 82 (78.8%) were offered 17-OHP-C. Of these, thirty-four (41.5%) declined. The median gestational age of the most recent preterm delivery was significantly lower among subjects who accepted 17-OHP-C as compared to those who declined (28.7 vs. 34.0 weeks,P=.02) and in subjects offered 17-OHP-C compared to those not offered 17-OHP-C (30.2 vs. 36.0 weeks,P=.03). Subjects not offered 17-OHP-C were more likely to have had an interval term delivery (31.8% vs. 9.7%,P=.009)Conclusion. Women with earlier preterm deliveries were more likely to be offered and accept 17-OHP-C. Prior obstetric history may influence both providers' and patients' willingness to discuss and/or accept 17-OHP-C.

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12: Pharmacological actions of progesterone (P4) or 17-alpha-hydroxyprogesterone caproate (17P) to inhibit cervical ripening or prevent term delivery depend upon the route of administration and effects on the myometrium

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2009.10.027 ◽

2009 ◽

Vol 201 (6) ◽

pp. S8

Author(s):

Ruben-J. Kuon ◽

Holger Maul ◽

Christof Sohn ◽

James Balducci ◽

Robert E. Garfield

Keyword(s):

Route Of Administration ◽

Cervical Ripening ◽

Term Delivery ◽

Hydroxyprogesterone Caproate

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Exposure to the Synthetic Progestin, 17α-Hydroxyprogesterone Caproate During Development Impairs Cognitive Flexibility in Adulthood

Endocrinology ◽

10.1210/en.2015-1775 ◽

2016 ◽

Vol 157 (1) ◽

pp. 77-82 ◽

Cited By ~ 17

Author(s):

Jari Willing ◽

Christine K. Wagner

Keyword(s):

Prefrontal Cortex ◽

Progesterone Receptor ◽

Medial Prefrontal Cortex ◽

Cognitive Flexibility ◽

Neural Circuit ◽

Developing Brain ◽

Premature Delivery ◽

Cognitive Behaviors ◽

Hydroxyprogesterone Caproate ◽

Cell Layers

Abstract The synthetic progestin, 17α-hydroxyprogesterone caproate, is increasingly used for the prevention of premature birth in at-risk women, despite little understanding of the potential effects on the developing brain. Rodent models suggest that many regions of the developing brain are sensitive to progestins, including the mesocortical dopamine pathway, a neural circuit important for complex cognitive behaviors later in life. Nuclear progesterone receptor is expressed during perinatal development in dopaminergic cells of the ventral tegmental area that project to the medial prefrontal cortex. Progesterone receptor is also expressed in the subplate and in pyramidal cell layers II/III of medial prefrontal cortex during periods of dopaminergic synaptogenesis. In the present study, exposure to 17α-hydroxyprogesterone caproate during development of the mesocortical dopamine pathway in rats altered dopaminergic innervation of the prelimbic prefrontal cortex and impaired cognitive flexibility with increased perseveration later in life, perhaps to a greater extent in males. These studies provide evidence for developmental neurobehavioral effects of a drug in widespread clinical use and highlight the need for a reevaluation of the benefits and potential outcomes of prophylactic progestin administration for the prevention of premature delivery.

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27: 17 alpha-hydroxyprogesterone caproate in women with previous preterm delivery: does a previous term delivery influence effectiveness?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2010.10.036 ◽

2011 ◽

Vol 204 (1) ◽

pp. S17

Author(s):

John R. Barton ◽

Lucy A. Barton ◽

Niki Istwan ◽

Debbie Rhea ◽

Cheryl Desch ◽

...

Keyword(s):

Preterm Delivery ◽

Term Delivery ◽

Hydroxyprogesterone Caproate

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Progesterone Receptor Polymorphisms and Clinical Response to 17-α-hydroxyprogesterone Caproate

Obstetric Anesthesia Digest ◽

10.1097/01.aoa.0000414104.72138.95 ◽

2012 ◽

Vol 32 (2) ◽

pp. 120-121

Author(s):

T. A. Manuck ◽

Y. Lai ◽

P. J. Meis ◽

M. P. Dombrowski ◽

B. Sibai ◽

...

Keyword(s):

Progesterone Receptor ◽

Clinical Response ◽

Hydroxyprogesterone Caproate

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Role of hydroxyprogesterone caproate injection in prevention of preterm labour in high risk patients for preterm delivery.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.08.3435 ◽

2019 ◽

Vol 26 (08) ◽

pp. 1242-1245

Author(s):

Saima Ashraf ◽

Iqra Imtiaz

Keyword(s):

High Risk ◽

Preterm Labour ◽

Fetal Membrane ◽

Weekly Basis ◽

High Risk Patients ◽

Membrane Rupture ◽

Term Delivery ◽

Hydroxyprogesterone Caproate ◽

Risk Patients

Preterm labour is occurrence of labour after 24 completed weeks of gestation and before 37 weeks of gestation are completed. In Asia preterm birth rate is quoted to be 9.1% while in Pakistan it is 15.7%. To establish role of hydroxyprogesterone caproate injection in prevention of preterm labour in high risk patients for pre-term delivery. Study Design: Descriptive case series. Setting: Obstetrics & Gynaecology Department at Nishtar Hospital Multan. Period: 25th October 2017 to 25th April 2018. Materials and Methods: 148 pregnant patients who were at high risk of pre-term delivery, women with any parity and singleton pregnancy and ongoing pregnancy between 24 to 36 gestational weeks were taken in the study. Patients having multiple pregnancy, fetal membrane rupture, having any contraindication to progesterone or taking medicines having interaction with progesterone were excluded from the study. All patients included in the study were given 250mg/ml hydroxyprogesterone caproate injection on weekly basis by intramuscular route. Injections were given till 36 completed gestational weeks or till the time of delivery which ever happened earlier. Patients who had pre-term delivery were managed as per standard protocol. Information was recorded in form of efficacy on a specially design proforma. Results: In the study range of age was 18-35 years and mean was 28.486 ± 2.79 years. 30.405 ± 2.42 weeks was mean for gestational age. Mean for prior pre-term delivery was 0.520 ± 0.83 and 26.398± 1.44 kg/m2 was mean BMI. 70.3% patients showed efficacy of drug. Conclusion: Results of study showed that hydroxyprogesterone caproate injection given as 250mg/ml on weekly basis causes significant decline in occurrence of recurrent pre-term delivery in high risk patients for pre-term delivery.

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