Vaginal Versus Intramuscular Progesterone for the Prevention of Recurrent Preterm Birth

NCT ID: NCT02913495

Last Updated: 2021-10-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

205 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-30

Study Completion Date

2021-09-30

Brief Summary

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The purpose of this study is to evaluate the two suggested therapies for prevention of recurrent preterm birth (PTB) in women with a prior spontaneous preterm birth, vaginal and intramuscular progesterone to determine whether vaginal progesterone is superior to intramuscular progesterone in the prevention of recurrent preterm birth.

Detailed Description

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Preterm birth is one of the leading causes of neonatal morbidity and mortality. One of the greatest predictors of preterm birth is a history of prior spontaneous preterm birth. Presently 17 hydroxyprogesterone caproate (intramuscular) is the only FDA approved product for the prevention of recurrent preterm birth, however recent studies suggest that vaginal progesterone may be used for this purpose, and may even be superior. The American College of Obstetrics and Gynecology does not specify the optimal route of progesterone administration for the prevention of recurrent preterm birth. It is our intention to compare vaginal and intramuscular progesterone to see if one is superior.

Conditions

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Premature Birth

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Vaginal Progesterone

200mg micronized progesterone vaginally, to be taken daily starting at 16 0/7 - 23 6/7 weeks, and continued daily until 36 6/7 weeks' gestation or delivery

Group Type EXPERIMENTAL

Vaginal Progesterone

Intervention Type DRUG

Intramuscular Progesterone

250mg intramuscular progesterone to be administered weekly starting at 16 0/7 - 23 6/7 weeks, and continued weekly until 36 6/7 weeks' or delivery.

Group Type ACTIVE_COMPARATOR

Intramuscular Progesterone (17 alpha hydroxprogesterone caproate)

Intervention Type DRUG

Interventions

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Vaginal Progesterone

Intervention Type DRUG

Intramuscular Progesterone (17 alpha hydroxprogesterone caproate)

Intervention Type DRUG

Other Intervention Names

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micronized progesterone Makena

Eligibility Criteria

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Inclusion Criteria

* Pregnant women with singleton pregnancies
* ≥18 years old
* Estimated gestational age less than 24 0/7 weeks
* Prior spontaneous preterm birth of a singleton pregnancy between 16 0/7-36 6/7 weeks.
* Patients are also required provide consent, demonstrate an understanding of the purpose of the study, and agree to the study protocol.

Exclusion Criteria

* History of an adverse reaction to progesterone;
* A contraindication to progesterone treatment;
* Placenta previa or accreta;
* Major fetal anomaly diagnosed on ultrasound or known chromosomal disorder;
* Multifetal gestation;
* Preterm labor, premature rupture of membranes, or clinical chorioamnionitis, at the time of enrollment
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Baystate Medical Center

OTHER

Sponsor Role collaborator

George Washington University

OTHER

Sponsor Role collaborator

Vriginia Commonwealth University

UNKNOWN

Sponsor Role collaborator

Ohio State University

OTHER

Sponsor Role collaborator

Thomas Jefferson University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rupsa C Boelig, MD

Role: PRINCIPAL_INVESTIGATOR

Thomas Jefferson University Hospital; Sidney Kimmel Medical College

Locations

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George Washington University

Washington D.C., District of Columbia, United States

Site Status

Baystate Medical Center

Springfield, Massachusetts, United States

Site Status

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

References

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Committee on Practice Bulletins-Obstetrics, The American College of Obstetricians and Gynecologists. Practice bulletin no. 130: prediction and prevention of preterm birth. Obstet Gynecol. 2012 Oct;120(4):964-73. doi: 10.1097/AOG.0b013e3182723b1b. No abstract available.

Reference Type BACKGROUND
PMID: 22996126 (View on PubMed)

Saccone G, Khalifeh A, Elimian A, Bahrami E, Chaman-Ara K, Bahrami MA, Berghella V. Vaginal progesterone vs intramuscular 17alpha-hydroxyprogesterone caproate for prevention of recurrent spontaneous preterm birth in singleton gestations: systematic review and meta-analysis of randomized controlled trials. Ultrasound Obstet Gynecol. 2017 Mar;49(3):315-321. doi: 10.1002/uog.17245. Epub 2017 Feb 6.

Reference Type BACKGROUND
PMID: 27546354 (View on PubMed)

Boelig RC, Schoen CN, Frey H, Gimovsky AC, Springel E, Backley S, Berghella V. Vaginal progesterone vs intramuscular 17-hydroxyprogesterone caproate for prevention of recurrent preterm birth: a randomized controlled trial. Am J Obstet Gynecol. 2022 May;226(5):722.e1-722.e12. doi: 10.1016/j.ajog.2022.02.012. Epub 2022 Feb 19.

Reference Type DERIVED
PMID: 35189093 (View on PubMed)

Other Identifiers

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16D.542

Identifier Type: -

Identifier Source: org_study_id