Randomized Controlled Trial of Vaginal Progesterone in Women With Threatened Preterm Labor (PROTO)
Pilot Randomized Controlled Trial of Vaginal Progesterone to Prevent Preterm Birth in Women With Threatened Preterm Labor
Prematurity remains the most important single factor in perinatal morbidity and mortality. Unfortunately, the rate of premature delivery is increasing in Canada and is especially high in Alberta with 7.5% of pregnancies ending before 37 weeks gestation. Despite years of research into the causes of spontaneous preterm labor, few effective treatments have been identified. Progesterone is one candidate treatment. The purpose of this study is to investigate whether progesterone can prolong pregnancy in women who have symptoms of preterm labor.
Pregnant women who have symptoms of premature labor will be invited to take part in the study if they are between 22 to 24 weeks pregnant. If they agree to join the study, they will be randomly allocated to either take progesterone 200mg each day via the vagina until 36 weeks, or to take a placebo preparation. Neither the women nor their clinician will know which group they are in.
Women and their babies will be followed until 28 days after the birth, to find out about the length of the pregnancy, any adverse events that might occur (none have been reported in previous trials), and to look at whether women have taken the treatment.
When the study is complete, the results for the progesterone group will be compared to the placebo group. If progesterone is found to be useful in helping to prolong pregnancy, then this will be a possible treatment to help mothers in the future.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Alberta
-
Calgary, Alberta, Canada, T2N 4J8
- Foothills Medical Centre
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Women with symptomatic premature contractions successfully arrested for at least 12 hours with tocolytics.
- Women with symptoms suggestive of early preterm labor whose contractions resolve without tocolysis but are fetal fibronectin positive.
- Gestational age 23(+0)-32(+6) weeks.
- Consent to taking part in the study.
Exclusion Criteria:
- Placenta previa
- Preterm premature rupture of membranes at presentation
- Pre-existing hypertension will be excluded in order to reduce the likelihood of iatrogenic preterm delivery within the study women
- Known major fetal anomaly detected on ultrasound
- Multiple pregnancy
- Maternal seizure disorder
- Active or history of thromboembolic disease
- Maternal liver disease
- Known or suspected breast malignancy or pathology
- Known or suspected progesterone-dependent neoplasia
- Plans to move to another city during pregnancy
- Previous participation in a progesterone trial during this pregnancy
- Known sensitivity to progesterone
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Placebo
|
Capsules of placebo (sunflower oil).
One capsule inserted vaginally per day from time of randomisation to gestational age 35(+6)weeks or delivery (if sooner).
|
|
Experimental: Vaginal progesterone
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Capsules of 200mg micronised progesterone suspended in sunflower oil.
One capsule inserted vaginally per day from time of randomisation to gestational age 35(+6)weeks or delivery (if sooner).
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Gestational age at birth
Time Frame: At birth
|
Gestational age at birth calculated from gestational age at pre-randomization baseline
|
At birth
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Proportion of women who have preterm birth <35 weeks
Time Frame: At birth
|
At birth
|
|
|
Proportion of women who have a preterm birth at <37 weeks
Time Frame: At birth
|
At birth
|
|
|
Maternal hospital length of stay (days)
Time Frame: Days from date of admission to date of discharge
|
Days from date of admission to date of discharge
|
|
|
Proportion of women who have hospital admission for premature labor
Time Frame: After birth
|
After birth
|
|
|
Maternal compliance with treatment
Time Frame: At time of birth
|
Diary self-report of treatment use
|
At time of birth
|
|
Neonatal hospital length of stay (days)
Time Frame: Days from birth to discharge from hospital
|
Days from birth to discharge from hospital
|
|
|
Neonatal morbidity
Time Frame: Up to 28 days after birth
|
Respiratory distress syndrome (type 1), intraventricular hemorrhage, chronic lung disease, periventricular leukomalacia,necrotising eneterocolitis, retinopathy of prematurity
|
Up to 28 days after birth
|
|
Number of days of assisted ventilation (neonate)
Time Frame: Up to 28 days after birth
|
Up to 28 days after birth
|
|
|
Number of days of supplemental oxygen (for neonate)
Time Frame: Up to 28 days after birth
|
Up to 28 days after birth
|
|
|
Birth weight (grams)
Time Frame: At time of birth
|
At time of birth
|
|
|
Neonatal survival to discharge home (yes/no)
Time Frame: During 28 days after birth
|
During 28 days after birth
|
|
|
Adverse events (maternal or neonate)
Time Frame: Up to 28 days after birth
|
Up to 28 days after birth
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Stephen Wood, MD, MSc, University of Calgary
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 21492
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