The efficiency of 17α Hydroxyprogesterone in prevention of preterm labor irrespective of the route of administration; Systematic Review Metanalysis

Skills / interests: Clinical peer review


Study design; systemic review Meta analysis

Aim of the study; to verify progesterone use throughout the second half of pregnancy may prevent preterm labor among women with short cervix less than 2.5 cm length or women with previous preterm labor utilizing either natural progesterone or given im injection or locally applied preparation via vaginal route

Study design; three articles have been chosen to participate in this Meta analysis. The first was a summary of Cochrane review published in 2020 in which women with previous preterm labor were given 17α hydroxyprogesterone im while women with short cervix were given progesterone vaginally. The second review was randomized controlled trial which was based on recruiting women with short cervix less than 2.5 cm long and was given local vaginal progesterone preparation throughout the second half of pregnancy. Finally the third randomized controlled trial used natural progesterone given on history alone by intramuscular route. All studies were placebo controlled.

Results; the study of this Meta Analysis shows no significant benefit of progesterone replacement in prolongation of pregnancy beyond 34 and 37 weeks of gestation with total fixed model odd ratio equal to 0.829 and 95% CI equivalent to 0.656 to 1.048, P value equal to 0.116 between the progesterone treated group versus placebo control group

Conclusion; there is some evidence that locally applied progesterone to short cervix may have more beneficial effect in pregnancy prolongation over the systemically administered progesterone, yet more studies are needed to confirm it

Key word;  threatened preterm labor, progesterone, short cervix. 

Ideal applicant

It is my first analysis and hope it provide something to the Cochran community


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Questions & comments

Thank you all for your support and awards My most acknowledged colleagues Wisam Akram

Default profile Wisam Akram (Task Poster) - 8 months ago

I shall be such acknowledged to hear from you about my first Metanalysis! Thank you very much Wisam Akram

Default profile Wisam Akram (Task Poster) - 8 months ago