Home > Journals > Minerva Ginecologica > Past Issues > Minerva Ginecologica 2019 April;71(2) > Minerva Ginecologica 2019 April;71(2):121-4

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Publication history
Reprints
Permissions
Cite this article as

 

REVIEW  UPDATES ON MATERNAL FETAL MEDICINE 

Minerva Ginecologica 2019 April;71(2):121-4

DOI: 10.23736/S0026-4784.18.04335-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Effects of progestogens in women with preterm premature rupture of membranes

Rossana DI SARNO, Antonio RAFFONE, Gabriele SACCONE

Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy



Different strategies have been adopted for prevention of spontaneous preterm birth, including use of progestogens. So far, five randomized trials have been published evaluating the efficacy of progestogens in women with PPROM, including a total of 425 participants. All the five trials enrolled pregnant women with singleton pregnancies randomized between 20 and 34 weeks of gestation. In four trials women were randomized to either weekly intramuscular 250 mg 17α-hydroxyprogesterone-caproate or placebo, while Mirzaei et al. was a three arms trials in which women received weekly intramuscular 250 mg 17α-hydroxyprogesterone-caproate, or rectal progesterone 400 mg daily, or no treatment. In all the trials, latency antibiotics were used, and tocolysis was used permitted for first 48 hours at discretion of attending physician. Recently a meta-analysis including the five trials has been published. They found that when compared to placebo weekly intramuscular 250 mg 17α-hydroxyprogesterone-caproate did not alter the latency period to delivery in singleton gestations with PPROM. Additionally, there was no difference in gestational age at delivery between groups or in mode of delivery. No significant differences were reported in maternal or neonatal outcomes, with latency not significantly altered in sensitivity analyses. So far, no trials have been published evaluating natural vaginal progesterone in women with PPROM.


KEY WORDS: Cerclage - Pessary - Progesterone - Cesarean delivery

top of page