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Progesterone Gives Mixed Results in Preventing Premature Delivery
Two trials of progesterone to reduce prematurity provide disparate results. The studies appear in the current New England Journal of Medicine.
The first study randomized 250 women with cervical lengths 15 mm or less to receive either daily intravaginal progesterone or placebo. The relative risk for spontaneous delivery before 34 weeks' gestation was 0.56 in the progesterone group.
The second study randomized 655 women with twin gestations to either weekly injections of 17 alpha-hydroxyprogesterone caproate or placebo. In that trial there were no differences in outcome.
Although the authors of the first study say that their results support use of progesterone in women with a short cervix, an editorialist, citing "uncertainties about both efficacy and fetal safety" concludes that the drug "is not yet ready to enter the therapeutic armamentarium as a pregnancy-prolonging agent."
Link: NEJM article on short-cervix prematurity (Free abstract with one-time registration; full text requires subscription)
Link: NEJM article on prematurity in twins (Free abstract with one-time registration; full text requires subscription)
Link: NEJM editorial (Subscription required)
Link: Journal Watch General Medicine coverage (Free)
Link: Journal Watch Women's Health coverage of article 1 (Free)
Link: Journal Watch Women's Health coverage of article 2 (Free)
Published in Physician's First Watch August 2, 2007
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