HealthDay News — For women with a prior preterm birth, cerclage plus 17α-hydroxyprogesterone caproate is associated with a significant reduction in delivery at less than 24 weeks of gestation compared with cerclage alone, according to a study published in the November issue of Obstetrics & Gynecology.

Bethany Stetson, MD, from the Ohio State Wexner Medical Center in Columbus, and colleagues identified women with transvaginal cerclage placement and a prior delivery between 16 and 36 weeks of gestation over a 10-year period. Outcomes, including the primary outcome of delivery at less than 24 weeks of gestation, were compared for women with a cerclage alone (171 women) and those with cerclage plus 17α-hydroxyprogesterone caproate (89 women).

The researchers found that delivery at less than 24 weeks of gestation occurred in 6 and 16% of women receiving cerclage plus 17α-hydroxyprogesterone caproate and cerclage alone (odds ratio, 0.31). The combined treatment group had a 73% reduction in delivery compared with the cerclage-alone group after the researchers controlled for indomethacin use, prior cerclage, and loop electrosurgical excision procedure-cold knife cone and cerclage surgery (adjusted odds ratio, 0.26).

“Women receiving transvaginal cerclage plus 17α-hydroxyprogesterone caproate had a 69% relative reduction in delivery at less than 24 weeks of gestation when compared with women receiving cerclage alone,” the authors write.

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