- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03537287
Different Types of Progesterone in the Prevention of Preterm Labor
Intramuscular 17Alpha-hydroxyprogestrone, Progesterone Suppositories and Dydrogesterone Tablets in Preventing Preterm Labor
Preterm birth is a common problem in obstetric care,with estimates ranging from 5% in several European countries to 18% in some African countries, Preterm labor defined as delivery before 37 completed weeks is the leading cause of perinatal and neonatal morbidity and mortality and strongly related to the developmental and neurological disabilities later in life..
There is still considerable uncertainty regarding the optimal progesterone type, route of administration, dosage and timing of start of therapy to prevent preterm labor in risky women
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This study aims to compare between the efficacy of intramuscular 17alpha-hydroxyprogestrone, progesterone vaginal suppositories and dydrogesterone oral tablets in prevention of preterm labor in high risk women.
All women will be counseled regarding mode of intervention and informed consent will be obtained. All cases will be subjected to complete history taking, routine antenatal examination and investigations, treatment of genital or urinary tract infections if diagnosed. Routine obstetric ultrasound examination and measurement of cervical length by transvaginal ultrasound will be carried out at 16-18weeks of pregnancy.
The study population will be randomly distributed according to the mode of intervention into 3 groups.
Randomization is performed using a Computer-generated randomization system. Blinding of the intervention is not feasible in this trial (owing to the different route of administration of the studied drugs).Table of randomization is obtained
Group 1:
Women who will take intramuscular 17 alpha hydroxyprogestrone caproate
Dose:
250 mg intramuscularly, once weekly starting from 16 weeks till delivery or 36 weeks.
Group 2 :
Women who will take progesterone 200mg vaginal suppositories.
Dose:
Once per day starting from 16 weeks till delivery or 36 weeks
Group 3 :
Women who will take oral dydrogesterone
Dose:
Take 2 tablets a day starting from 16 weeks till delivery or 36 weeks
Color Doppler blood flow velocity examination of fetal circulation will be performed by an independent investigator blinded to treatment before treatment &after two weeks of treatment.
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Abbaseya
-
Cairo, Abbaseya, Egypt
- Recruiting
- Ain Shams Maternity Hospital
-
Contact:
- Mohamed Samy, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Singleton pregnancy
- Living fetus with gestational age 16-18weeks (calculated according to date of last menstrual period confirmed with earlier ultrasound examination).
Presence of risk factor for preterm labor:
- Previous spontaneous preterm labor in previous singleton Pregnancy, OR
- Previous spontaneous second trimestric miscarriage less than 3 times, OR
- Short cervix less than 25mm diagnosed during midtrimesteric transvaginal ultrasound examination at 16-18 weeks with or without history of previous preterm labor.
Exclusion Criteria:
- Multiple pregnancy.
- Medical or obstetric conditions requiring termination of pregnancy
Contraindication to progesterone administration or its use earlier in this pregnancy
- Current or past history of thrombophlebitis, thromboembolic disorders, or cerebral apoplexy.
- Liver dysfunction or disease.
- Known or suspected malignancy of breast or genital organs.
- Undiagnosed vaginal bleeding.
- Missed abortion.
- Known sensitivity to progesterone injection.
- Known sensitivity to sesame oil/seeds.
- Congenital fetal anomalies
- Cervical cerclage in the current pregnancy.
- Presence of uterine anomalies (Unicornuate uterus , Uterus didelphys, bicornuate uterus,Septated uterus) or uterine fibroid.
- Presence of history of chronic hypertetion, chronic liver or kidney diseases, and pregnancy induced hypertension.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: 17 alpha hydroxyprogestrone caproate Group
Patients will receive 250 mg of 17 alpha hydroxyprogestrone caproate intramuscularly once weekly starting from 16 weeks till delivery or 36 weeks.
|
250 mg of 17 alpha hydroxyprogestrone caproate weekly
|
Active Comparator: Vaginal progesterone Group
Patients will receive vaginal progesterone 200 mg once per day starting from 16 weeks till delivery or 36 weeks.
|
200 mg of vaginal progesterone daily
|
Active Comparator: Oral dydrogesterone Group
Patients will receive 2 tablets of oral dydrogesterone daily starting from 16 weeks till delivery or 36 weeks
|
2 tablets of dydrogesterone daily
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Gestational age in weeks at delivery.
Time Frame: 6 months
|
using either the last menstrual period in patients with regular cycles or early first trimester ultrasound to calculate the gestational age in weeks at delivery
|
6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Hemodynamic changes in fetoplacental circulation
Time Frame: 6 months
|
Measurement of U/S Doppler indices of umbilical artery and middle cerebral artery (namely PI, RI and S/D ratio) in fetal circulation
|
6 months
|
Unsatisfactory response
Time Frame: 6 months
|
Number of patients who needed to increase the dose above the recommended initial dose.
|
6 months
|
Failure of prevention of preterm labor
Time Frame: 6 months
|
Number of patients who suffered preterm labor and needed tocolysis
|
6 months
|
Birth weight
Time Frame: 6 months
|
Birth weight in Kg
|
6 months
|
Neonatal APGAR score
Time Frame: 6 months
|
Neonatal Apgar score at 1 and 5 min.
|
6 months
|
Need for NICU admission
Time Frame: 6 months
|
Number of patients whose neonates were admitted to NICU Neonatal mortality. |
6 months
|
Neonatal mortality
Time Frame: 6 months
|
Number of neonatal deaths
|
6 months
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- PDPTL
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Preterm Labor
-
Istanbul University - Cerrahpasa (IUC)CompletedPreterm Labor | Preterm Spontaneous Labor With Preterm Delivery | Preterm Labor With Preterm Delivery in Third TrimesterTurkey
-
University Hospital, Strasbourg, FranceRecruitingPreterm Delivery | Threatened Preterm LaborFrance
-
Ain Shams UniversityRecruitingPreterm Labor With Preterm DeliveryEgypt
-
PreTeL, IncDuke University; University of RochesterRecruitingPreterm Birth | Threatened Preterm Labor | PreTerm LaborUnited States
-
University of Modena and Reggio EmiliaNot yet recruitingPreterm Labor With Preterm DeliveryItaly
-
Konya Meram State HospitalRecruitingPregnancy Preterm | Preterm Labor Without DeliveryTurkey
-
e-Bio CorpRecruitingPreterm Labor | PreTerm Birth | Preterm Labor With Delivery NosUnited States
-
Hospital Clinico Universitario de SantiagoFundación Ramón DomínguezWithdrawnThreatened Preterm Labor
-
Tel-Aviv Sourasky Medical CenterUnknownLabor Preterm Multiple
-
Shiraz University of Medical SciencesCompletedManaging Preterm Labor
Clinical Trials on 17 alpha hydroxyprogestrone caproate
-
The George Washington University Biostatistics...Eunice Kennedy Shriver National Institute of Child Health and Human Development...CompletedPreterm BirthUnited States
-
University of PittsburghEunice Kennedy Shriver National Institute of Child Health and Human Development... and other collaboratorsCompleted
-
Steve N. Caritis, MDAMAG Pharmaceuticals, Inc.Terminated
-
Assistance Publique - Hôpitaux de ParisCompletedPreterm DeliveryFrance
-
The George Washington University Biostatistics...Eunice Kennedy Shriver National Institute of Child Health and Human Development...CompletedPregnancy | Preterm Birth | MultifetalUnited States
-
University of North Carolina, Chapel HillEunice Kennedy Shriver National Institute of Child Health and Human Development... and other collaboratorsCompleted
-
Obstetrix Medical GroupCompletedPreterm BirthUnited States
-
Yale UniversityWithdrawnPremature Birth | Premature Labor
-
Obstetrix Medical GroupCompletedPreterm DeliveryUnited States
-
Lehigh Valley HospitalTerminatedMid Trimester Cervical ShorteningUnited States