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17 OHP ‐C in patients with spontaneous preterm labor and intact membranes: is there an effect according to the presence of intra‐amniotic inflammation?
Author(s) -
Yoneda Satoshi,
Yoneda Noriko,
Shiozaki Arihiro,
Yoshino Osamu,
Ueno Tomohiro,
Niimi Hideki,
Kitajima Isao,
Tamura Kentaro,
Kawasaki Yukako,
Makimoto Masami,
Yoshida Taketoshi,
Saito Shigeru
Publication year - 2018
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/aji.12867
Subject(s) - amniotic fluid , medicine , inflammation , group b , chorioamnionitis , gestational age , retrospective cohort study , group a , preterm labor , obstetrics , subgroup analysis , gastroenterology , pregnancy , gestation , fetus , confidence interval , biology , genetics
Problem It is not known whether 17‐alpha‐hydroxyprogesterone caproate (17 OHP ‐C) is effective for preventing preterm delivery with an episode of preterm labor ( PTL ) with or without intra‐amniotic inflammation/infection. Methods of study This was a retrospective cohort study. One hundred and seven PTL patients were selected and divided into a 17 OHP ‐C group (use of 17 OHP ‐C: n = 53) and a no‐treatment group (no use of 17 OHP ‐C: n = 54). Moreover, the patients were divided into three subgroups (subgroup A: without intra‐amniotic inflammation, B: with mild intra‐amniotic inflammation, and C: with severe intra‐amniotic inflammation) according to their level of amniotic interleukin ( IL )‐8, and perinatal prognosis was analyzed. Results Interval from admission to delivery (days) in the 17 OHP ‐C group (76 [13‐126], n = 34) was significantly longer than that in the no‐treatment group (50 [8‐104], n = 33; P = .012) in subgroup B. In cases without intra‐amniotic microbes in subgroup B, a significant prolongation of gestational days was associated with the 17 OHP ‐C group (79 [13‐126], n = 25) compared with the no‐treatment group (50 [8‐104], n = 29; P = .029). However, there were no significant differences in subgroups A or C. Conclusion 17 OHP ‐C could prolong gestational period in limited PTL cases with sterile mild intra‐amniotic inflammation.