Role of hydroxyprogesterone caproate injection in prevention of preterm labour in high risk patients for preterm delivery.

Abstract

Preterm labour is occurrence of labour after 24 completed weeks of gestation and before 37 weeks of gestation are completed. In Asia preterm birth rate is quoted to be 9.1% while in Pakistan it is 15.7%. To establish role of hydroxyprogesterone caproate injection in prevention of preterm labour in high risk patients for pre-term delivery. Study Design: Descriptive case series. Setting: Obstetrics & Gynaecology Department at Nishtar Hospital Multan. Period: 25th October 2017 to 25th April 2018. Materials and Methods: 148 pregnant patients who were at high risk of pre-term delivery, women with any parity and singleton pregnancy and ongoing pregnancy between 24 to 36 gestational weeks were taken in the study. Patients having multiple pregnancy, fetal membrane rupture, having any contraindication to progesterone or taking medicines having interaction with progesterone were excluded from the study. All patients included in the study were given 250mg/ml hydroxyprogesterone caproate injection on weekly basis by intramuscular route. Injections were given till 36 completed gestational weeks or till the time of delivery which ever happened earlier. Patients who had pre-term delivery were managed as per standard protocol. Information was recorded in form of efficacy on a specially design proforma. Results: In the study range of age was 18-35 years and mean was 28.486 ± 2.79 years. 30.405 ± 2.42 weeks was mean for gestational age. Mean for prior pre-term delivery was 0.520 ± 0.83 and 26.398± 1.44 kg/m2 was mean BMI. 70.3% patients showed efficacy of drug. Conclusion: Results of study showed that hydroxyprogesterone caproate injection given as 250mg/ml on weekly basis causes significant decline in occurrence of recurrent pre-term delivery in high risk patients for pre-term delivery.