Effects of Progesterone on Latency Period in Patients with Preterm Premature Rupture of Membranes during ۲۴-۳۴ Weeks of Pregnancy

Background & Aims: Preterm premature rupture of membranes (PPROM) is the leading cause of preterm birth and perinatal mortality and morbidity, and complications. The objective of the present study was to assess the effect of progesterone agents (rectal suppositories and weekly injection of ۱۷- hydroxyprogesterone caproate) on latency period in women with PPROM. Methods: This randomized, double-blind study included ۱۷۱ pregnant women with PPROM between ۲۴ and ۳۴ weeks of gestation. The participants were randomized into ۳ groups; ۱۷-hydroxyprogesterone caproate (n = ۵۷), rectal progesterone (n = ۵۷), no treatment (n = ۱۰۲). The first group was administered rectal progesterone ۴۰۰ mg daily, second group ۱۷-hydroxyprogesterone caproate ۲۵۰ mg weekly, and the third group was not administered any medicine. The ۳ groups were followed until delivery. All groups were compared in terms of latency period duration, gestational age and weight at delivery, chorioamnionitis, neonatal infections, neonatal and fetal mortality, and sepsis. Data analysis was performed using SPSS, chisquare and Kruskal-Wallistests. Results: Gestational age at the time of rupture of membranes (P = ۰.۶۶۴) and parity (P = ۰.۲۷۵) were similar in the ۳ groups. The duration of the latency period was significantly longer among the progesterone groups (P = ۰.۰۰۶) compared with the no treatment group. The ۳ groups were significantly different in terms of gestational age at delivery (P = ۰.۳۷۸), mode of delivery (P = ۰.۸۴۵), birth weight (P = ۰.۱۸۵), admission at neonatal intensive-care unit )NICU( (P = ۰.۳۳۶), and chorioamnionitis prevalence (P = ۰.۹۱۵). Conclusion: Progesterone agents may prolong the latency period in women with PPROM, but its effect on pregnancy outcome is uncertain. Further randomized trials are required to determine the effect of this treatment on pregnancy outcome

Keywords:

Preterm premature rupture of membrane (PPROM) , Progesterone suppository , ۱۷- hydroxyprogesterone caproate , Latency period