Adjunctive Vaginal Progesterone in Management of Preterm Labor
Study Details
Study Description
Brief Summary
This study evaluates the addition of vaginal micronized progesterone effervescent to standard treatment in the treatment of preterm labor. Half of participants will receive vaginal micronized progesterone effervescent and standard treatment, while the other half will receive only standard treatment.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
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Phase 4 |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Active Comparator: Micronized progesterone
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Drug: Micronized progesterone
Vaginal micronized progesterone effervescent once daily until delivery
|
No Intervention: Control
|
Outcome Measures
Primary Outcome Measures
- latency period [13 weeks]
time from preterm labor to delivery
Secondary Outcome Measures
- gestational age at delivery [13 weeks]
mean gestational age at delivery
- preterm delivery less than 34 weeks [10 weeks]
percentage of preterm delivery less than 34 weeks
- preterm delivery less than 37 weeks [13 weeks]
percentage of preterm delivery less than 37 weeks
- neonatal complications [13 weeks]
percentage of newborn with RDS, IVH, NEC, death
- side effects [13 weeks]
percentage of side effects such as headache, nausea/vomiting
- compliance [13 weeks]
percentage of complete drug use
- good satisfaction [13 weeks]
percentage of good satisfaction
- good quality of life [13 weeks]
percentage of good quality of life
- Time to the recurrence of uterine contractions [13 weeks]
mean time to the recurrence of uterine contractions
Eligibility Criteria
Criteria
Inclusion Criteria:
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singleton pregnancy with gestational age 24-33 weeks 6 days
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preterm labor
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received treatment with tocolysis and corticosteroids
Exclusion Criteria:
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conditions that need immediate delivery such as fetal distress, chorioamnionitis
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have medical complications such as heart disease, seizure
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fetal anomalies
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cervical dilatation more than 5 cm
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allergy to progesterone
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contraindication to progesterone
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contraindication to tocolytic use
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Chulalongkorn University
Investigators
- Study Director: Vorapong Phupong, M.D., Chulalongkorn University
Study Documents (Full-Text)
None provided.More Information
Publications
- ACOG Practice Bulletin No.142: Cerclage for the management of cervical insufficiency. Obstet Gynecol. 2014 Feb;123(2 Pt 1):372-379. doi: 10.1097/01.AOG.0000443276.68274.cc.
- American College of Obstetricians and Gynecologists' Committee on Practice Bulletins-Obstetrics. Practice Bulletin No. 171: Management of Preterm Labor. Obstet Gynecol. 2016 Oct;128(4):e155-64. doi: 10.1097/AOG.0000000000001711.
- Cicinelli E, De Ziegler D, Morgese S, Bulletti C, Luisi D, Schonauer LM. "First uterine pass effect" is observed when estradiol is placed in the upper but not lower third of the vagina. Fertil Steril. 2004 May;81(5):1414-6. doi: 10.1016/j.fertnstert.2003.12.016.
- Coomarasamy A, Devall AJ, Cheed V, Harb H, Middleton LJ, Gallos ID, Williams H, Eapen AK, Roberts T, Ogwulu CC, Goranitis I, Daniels JP, Ahmed A, Bender-Atik R, Bhatia K, Bottomley C, Brewin J, Choudhary M, Crosfill F, Deb S, Duncan WC, Ewer A, Hinshaw K, Holland T, Izzat F, Johns J, Kriedt K, Lumsden MA, Manda P, Norman JE, Nunes N, Overton CE, Quenby S, Rao S, Ross J, Shahid A, Underwood M, Vaithilingam N, Watkins L, Wykes C, Horne A, Jurkovic D. A Randomized Trial of Progesterone in Women with Bleeding in Early Pregnancy. N Engl J Med. 2019 May 9;380(19):1815-1824. doi: 10.1056/NEJMoa1813730.
- Coomarasamy A, Williams H, Truchanowicz E, Seed PT, Small R, Quenby S, Gupta P, Dawood F, Koot YE, Atik RB, Bloemenkamp KW, Brady R, Briley A, Cavallaro R, Cheong YC, Chu J, Eapen A, Essex H, Ewies A, Hoek A, Kaaijk EM, Koks CA, Li TC, MacLean M, Mol BW, Moore J, Parrott S, Ross JA, Sharpe L, Stewart J, Trepel D, Vaithilingam N, Farquharson RG, Kilby MD, Khalaf Y, Goddijn M, Regan L, Rai R. PROMISE: first-trimester progesterone therapy in women with a history of unexplained recurrent miscarriages - a randomised, double-blind, placebo-controlled, international multicentre trial and economic evaluation. Health Technol Assess. 2016 May;20(41):1-92. doi: 10.3310/hta20410.
- Facchinetti F, Vergani P, Di Tommaso M, Marozio L, Acaia B, Vicini R, Pignatti L, Locatelli A, Spitaleri M, Benedetto C, Zaina B, D'Amico R. Progestogens for Maintenance Tocolysis in Women With a Short Cervix: A Randomized Controlled Trial. Obstet Gynecol. 2017 Jul;130(1):64-70. doi: 10.1097/AOG.0000000000002065.
- Piette PCM. The pharmacodynamics and safety of progesterone. Best Pract Res Clin Obstet Gynaecol. 2020 Nov;69:13-29. doi: 10.1016/j.bpobgyn.2020.06.002. Epub 2020 Jun 25.
- Schumacher M, Liere P, Ghoumari A. Progesterone and fetal-neonatal neuroprotection. Best Pract Res Clin Obstet Gynaecol. 2020 Nov;69:50-61. doi: 10.1016/j.bpobgyn.2020.09.001. Epub 2020 Sep 8.
- Shiba R, Kinutani M, Okano S, Kawano R, Kikkawa Y. Efficacy of four vaginal progesterones for luteal phase support in frozen-thawed embryo transfer cycles: A randomized clinical trial. Reprod Med Biol. 2019 Sep 16;19(1):42-49. doi: 10.1002/rmb2.12300. eCollection 2020 Jan.
- Simunic V, Tomic V, Tomic J, Nizic D. Comparative study of the efficacy and tolerability of two vaginal progesterone formulations, Crinone 8% gel and Utrogestan capsules, used for luteal support. Fertil Steril. 2007 Jan;87(1):83-7. doi: 10.1016/j.fertnstert.2006.05.067. Epub 2006 Nov 1. Erratum In: Fertil Steril. 2007 Jul;88(1):254.
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