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17α-羟孕酮己酸酯预防早产临产成功保胎后的早产:一项随机对照试验。

Prevention of preterm delivery after successful tocolysis in preterm labor by 17 alpha-hydroxyprogesterone caproate: a randomized controlled trial.

机构信息

Department of Obstetrics, Hôpital Poissy-Saint Germain, Versailles-St Quentin University, Poissy, France.

出版信息

Am J Obstet Gynecol. 2012 Mar;206(3):206.e1-9. doi: 10.1016/j.ajog.2011.12.026. Epub 2011 Dec 27.

Abstract

OBJECTIVE

The objective of the study was to evaluate the use of 17 alpha-hydroxyprogesterone caproate (17P) to reduce preterm delivery.

STUDY DESIGN

This open-label, multicenter, randomized controlled trial included women with singleton pregnancies admitted at 24-31 weeks' gestation and cervical length less than 25 mm for preterm labor successfully arrested by tocolytic treatment. Randomization assigned them to receive (or not) 500 mg of intramuscular 17P after tocolysis ended, repeated semiweekly until 36 weeks or preterm delivery. The primary outcome was the time from randomization to delivery.

RESULTS

Outcome data were available for 184 of 188 women randomized. The 17P and control groups (similar for most baseline characteristics) did not differ significantly for median [interquartile range] time to delivery (64 [42-79] and 67 [46-83] days, respectively) or rates of delivery before 37, 34, or 32 weeks of gestation or adverse perinatal outcomes.

CONCLUSION

Semiweekly injections of 17P did not prolong pregnancy significantly in women with tocolysis-arrested preterm labor.

摘要

目的

本研究旨在评估 17α-羟孕酮己酸酯(17P)在减少早产中的应用。

研究设计

这是一项开放标签、多中心、随机对照试验,纳入了在 24-31 孕周因早产而接受保胎治疗成功、宫颈长度小于 25mm 的单胎妊娠妇女。随机分配她们在保胎治疗结束后接受(或不接受)500mg 肌肉注射 17P,每两周重复一次,直至 36 孕周或发生早产。主要结局为随机分组至分娩的时间。

结果

188 例随机分组的妇女中,184 例有结局数据。17P 组和对照组(大多数基线特征相似)的中位[四分位间距]分娩时间(分别为 64[42-79]和 67[46-83]天)或 37 周前、34 周前和 32 周前分娩率或不良围产结局发生率无显著差异。

结论

对于保胎治疗成功的早产孕妇,每周两次注射 17P 并不能显著延长妊娠时间。

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