Cervical cerclage versus weekly progesterone injection in prevention of preterm labor | ||
| The Egyptian Journal of Fertility and Sterility | ||
| Article 7, Volume 19, Issue 1 - Serial Number 11106352, January 2015, Pages 41-48 PDF (2.72 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/egyfs.2015.257493 | ||
| Author | ||
| Abdel-Samie Abdel Mahmoud El-Seheimy, Ahmed Taha Abdel Fatth1, 2, 3 | ||
| 1Faculty of Medicine, Fayoum University, OB/GYN Department | ||
| 2Faculty of Medicine, ALAzhar University, Assiut, OB/GYN Department | ||
| 3Faculty of Medicine, ALAzhar University, Cairo, OB/GYN Department | ||
| Abstract | ||
| Objective: Prematurity is the leading cause of neonatal death and handicap. Although all births before 37 weeks of gestation are defined as preterm, most damage and death occurs in infants delivered before 34 weeks. Improvements in neonatal care have led to higher rates of survival among very premature infants, but a major effect on the associated mortality and morbidity will be achieved by better Identification of women at high risk for preterm delivery and by development of an effective intervention to prevent this complication. The aim of this study is to compare the effect of weekly progesterone injection and cervical cerclage on the outcomes of pregnancy in patients with history of preterm labor. Materials & Methods: The study comprised of 80 patients involved in the study then, 20 patients were excluded from the study due to different causes. Patients were randomly allocated to two groups. Randomization was done by sealed envelopes. Group A: (30 patients); in this group we had given them 17 OH progesterone (cidulot depot 250 mg) IM weekly starting from 16-20 Weeks till 36 weeks gestation. Group B: (30 patients); in this group we had done cervical cerclage operation at 14 weeks. First we assessed the effect of cidulot depot on the gestational age in comparison to the gestational age at previous preterm deliveries in group A. Secondly we assessed the effect of cervical cerclage on the gestational age in comparison to the gestational age at previous preterm deliveries in group B. The primary outcome was the gestational age at time of delivery documented by the LMP and abdominal US. The secondary outcomes were the need to the tocolytic therapy, estimated fetal weight at the time of delivery, the neonatal outcome regarding admission to the incubator or the need to ICU admission and neonatal mortality. Results: of the study were analyzed, matched and compared. Conclusion: We concluded that the prophylactic administration of progesterone beginning in mid-gestation to women who previously had a preterm birth has been shown to reduce the rate of recurrence. Also use of prophylactic cervical cerclage reduces preterm labor but the preference of which method remains an area of discussion. | ||
| Keywords | ||
| Key Words: Preterm labor; 17-OH progesterone; cervical cerclage | ||
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