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Prevention of preterm delivery with 17-hydroxyprogesterone caproate: pharmacologic considerations

Maisa Feghali1, Raman Venkataramanan2, Steve Caritis1

  • 1Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA.

Seminars in Perinatology
|September 27, 2014
PubMed

Insights

17-hydroxyprogesterone caproate (17-OHPC) shows variable efficacy in preventing preterm birth. This review examines its pharmacology, clinical use, and safety to understand inconsistent outcomes in pregnant women.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Pharmacology

Background:

  • Preterm birth remains a significant global health challenge despite advances in neonatal care.
  • Current strategies for identifying and treating early pregnancy risk factors have not effectively reduced preterm birth rates.
  • Prophylactic 17-hydroxyprogesterone caproate (17-OHPC) therapy was introduced following a trial showing a 34% reduction in recurrent spontaneous preterm birth.

Purpose of the Study:

  • To review the scientific basis, clinical effectiveness, and safety profile of 17-hydroxyprogesterone caproate (17-OHPC) for preterm birth prevention.
  • To analyze pharmacokinetic and pharmacodynamic data of 17-OHPC.
  • To elucidate the reasons behind variable clinical efficacy and outcomes associated with 17-OHPC use.

Main Methods:

  • Comprehensive literature review of studies on 17-hydroxyprogesterone caproate (17-OHPC).
  • Examination of pharmacological properties, including drug metabolism and mechanism of action.
  • Analysis of clinical trial data regarding efficacy and safety in preterm birth prevention.

Main Results:

  • Initial clinical trials indicated that 17-hydroxyprogesterone caproate (17-OHPC) could reduce recurrent spontaneous preterm birth by 34%.
  • Subsequent research has revealed considerable variability in the drug's efficacy across different patient populations and studies.
  • Pharmacokinetic and pharmacodynamic data are crucial for understanding the observed inconsistencies in treatment outcomes.

Conclusions:

  • The efficacy of 17-hydroxyprogesterone caproate (17-OHPC) in preventing preterm birth is variable and requires further investigation.
  • Understanding the drug's pharmacology, metabolism, and pharmacodynamics is essential for optimizing its use and clarifying clinical outcomes.
  • Continued research is needed to refine the application of 17-OHPC and improve strategies for preterm birth prevention.

Keywords:
17-hydroxyprogesterone caproatePharmacologyPreterm deliveryPrevention

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