Effects of Progesterone on Latency Period in Patients with Preterm Premature Rupture of Membranes during 24-34 Weeks of Pregnancy

Abstract

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 17- hydroxyprogesterone caproate) on latency period in women with PPROM. Methods: This randomized, double-blind study included 171 pregnant women with PPROM between 24 and 34 weeks of gestation. The participants were randomized into 3 groups; 17-hydroxyprogesterone caproate (n = 57), rectal progesterone (n = 57), no treatment (n = 102). The first group was administered rectal progesterone 400 mg daily, second group 17-hydroxyprogesterone caproate 250 mg weekly, and the third group was not administered any medicine. The 3 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 = 0.664) and parity (P = 0.275) were similar in the 3 groups. The duration of the latency period was significantly longer among the progesterone groups (P = 0.006) compared with the no treatment group. The 3 groups were significantly different in terms of gestational age at delivery (P = 0.378), mode of delivery (P = 0.845), birth weight (P = 0.185), admission at neonatal intensive-care unit )NICU( (P = 0.336), and chorioamnionitis prevalence (P = 0.915). 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