The effect of 17-hydroxyprogesterone caproate on preterm birth in women with an ultrasound-indicated cerclage

We sought to determine if 17-hydroxyprogesterone caproate (17P) reduces the rate of preterm birth (PTB) in women with an ultrasound-indicated cerclage (UIC). We retrospectively reviewed a cohort of women with a previous spontaneous PTB and current UIC placement for cervical length (CL) < 25 mm at < 23⁶/weeks. The study group consisted of women treated with 17P; the control group consisted of women not treated with 17P. Primary outcome was spontaneous PTB < 35 weeks. Secondary outcomes included PTB < 32 weeks, PTB < 28 weeks, gestational age at delivery, and birth weight. A total of 58 women were identified; 15 (25.9%) received 17P, and 43 (74.1%) did not. 17P did not have a significant effect on PTB < 35 weeks (odds ratio 1.72, 95% confidence interval 0.50 to 5.89), nor did it have a significant effect on the secondary outcomes. Among women with a prior spontaneous PTB and current UIC for CL < 25 mm, 17P did not reduce the rate of PTB < 35 weeks.