Gel reduces the frequency of preterm birth in women with sonographically short cervix lengths
WEDNESDAY, April 20 (HealthDay News) -- Administration of vaginal progesterone gel in women with a sonographically short cervix in the second trimester is correlated with a significant reduction in the rate of preterm birth, according to a study published online April 6 in Ultrasound in Obstetrics & Gynecology.
Sonia S. Hassan, M.D., from the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Bethesda, Md., and colleagues investigated the efficacy and safety of micronized vaginal progesterone gel for reducing the risk of preterm birth and its related complications in women with a sonographically short cervix (10 to 20 mm). Asymptomatic women with a singleton pregnancy were randomized to receive vaginal progesterone gel (235 women) or placebo (223 women) every day starting from 20 to 23 weeks and six days, until 36 weeks and six days, membrane rupture, or delivery.
The researchers found that women in the vaginal progesterone group had a significantly lower rate of preterm birth before 33 weeks compared to those in the placebo group (relative risk [RR], 0.55). This effect persisted after adjusting for confounders. Vaginal progesterone was also correlated with a significantly reduced rate of preterm birth before 28 and 35 weeks (RR, 0.50 and 0.62, respectively). Respiratory distress syndrome, neonatal morbidity or mortality events, and birth weight less than 1,500 g were all significantly lower in the vaginal progesterone group.
"Universal screening of women with transvaginal cervical length in the midtrimester to identify patients at risk can now be coupled with an intervention -- the administration of vaginal progesterone gel -- to reduce the frequency of preterm birth and improve neonatal outcome," the authors write.
Several of the study authors disclosed financial relationships with Columbia Laboratories Inc., which partially funded the study. One of the study authors holds a patent for use of progesterone in the prevention of preterm birth.