Pregnancy outcomes of women receiving compounded 17 α-hydroxyprogesterone caproate for prophylactic prevention of preterm birth 2004 to 2011.

Objective: To examine pregnancy outcomes of women receiving weekly compounded 17 α-hydroxyprogesterone caproate (17P) injections through a home nursing program compared with those reported in a multicenter trial by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Network.

Methods: The study sample was comprised of patients receiving compounded 17P through a home nurse administration care management program. Included were women with current singleton gestation and prior spontaneous preterm birth (SPTB) initiating 17P between 16 and 20 weeks.

Influence of gestational age and reason for prior preterm birth on rates of recurrent preterm delivery.

Objective: We sought to compare rates of recurrent spontaneous preterm birth (SPTB) in women receiving 17-α-hydroxyprogesterone caproate (17P) with prior SPTB due to preterm labor (PTL) vs preterm premature rupture of membranes (PPROM).

Study Design: Women with singleton gestation having 1 prior SPTB enrolled at 16-24.9 weeks' gestation for weekly outpatient 17P administration were identified from a database.

Elective delivery at 34⁰(/)⁷ to 36⁶(/)⁷ weeks' gestation and its impact on neonatal outcomes in women with stable mild gestational hypertension.

Objective: To examine the frequency of elective delivery and neonatal outcomes in women with stable mild gestational hypertension delivering late preterm.

Study Design: The frequency of elective delivery between 1995 and 2007 at gestational age of 34⁰(/)⁷-36⁶(/)⁷ weeks (late preterm), 37⁰(/)⁷-37⁶(/)⁷ weeks, and ≥38⁰(/)⁷ weeks, as well as neonatal outcomes, were studied in singleton gestation with mild gestational hypertension without proteinuria from a large national database.

Results: One thousand eight hundred fifty-eight patients were studied: 607 (33%) were delivered for maternal/fetal reasons and 1251 (67%) were electively delivered.

Using 17 α-hydroxyprogesterone caproate to impact rates of recurrent preterm delivery in clinical practice.

Objective: Evaluation of an outpatient 17 α-hydroxyprogesterone caproate (17P) administration programme.

Methods: A retrospective analysis of data collected from patients with a history of preterm birth (PTB) and current singleton gestation enrolled between 16.0 and 20.

The reliability of patient-reported pregnancy outcome data.

Pregnancy and neonatal outcome information is frequently used in disease management to evaluate the cost-effectiveness of prenatal interventions and for other research and reporting activities. The purpose of this study was to determine if a telephone interview process is a reliable methodology for collecting pregnancy outcomes. High-risk patients from a large maternal-fetal medicine practice who received outpatient preterm labor management services from January 1996 to June 2001 were identified.

Uterine activity in women receiving 17 alpha-hydroxyprogesterone caproate for the prevention of preterm birth: an observational study.

We evaluated uterine contraction frequency in women receiving 17 alpha-hydroxyprogesterone caproate (17-OHP-C) for the prevention of preterm delivery. Women with singleton pregnancies and receiving weekly 17-OHP-C and outpatient tococardiography were identified from a database. The mean and maximum contraction frequencies per hour were compared from 3 days before to 3 days after 17-OHP-C dosing.

Preterm birth prevention by 17 alpha-hydroxyprogesterone caproate vs. daily nursing surveillance.

Objective: To compare the incidence of spontaneous recurrent preterm delivery (SPTD) between women receiving 17 alpha-hydroxyprogesterone caproate (17P) and women receiving daily perinatal nursing surveillance (dPNS) with home uterine activity monitoring.

Study Design: Women enrolled for dPNS or weekly nursing visits with 17P injection were eligible. Included were singletons with previous SPTD, without preterm labor (PTL), cerclage or vaginal bleeding and < 27 weeks at enrollment.

The impact of acute tocolysis on neonatal outcome in women hospitalized with preterm labor at 32 to 34 weeks' gestation.

We compared neonatal outcomes from singleton pregnancies in women hospitalized with preterm labor (PTL) at 32 0/7 to 34 6/7 weeks managed with and without acute tocolysis. Women enrolled for outpatient surveillance who were hospitalized and diagnosed with PTL between 32 0/7; to 34 6/7 weeks' gestation without conditions necessitating interventional delivery during hospitalization were identified ( N = 2921). Patients with contraindications to pregnancy prolongation were excluded ( N = 168).

Antenatal factors predicting subsequent need for insulin treatment in women with gestational diabetes.

Objective: To identify characteristics indicative of subsequent requirement of insulin in patients with gestational diabetes (GDM).

Methods: Identified from a database were patients with GDM not receiving insulin or oral hypoglycemic agents at enrollment for outpatient education and surveillance. Maternal characteristics were compared between patients achieving glycemic control with diet and those requiring insulin.

Management of recurrent preterm labor in twin gestations with nifedipine tocolysis.

We examined outcomes of twin pregnancies complicated by recurrent preterm labor receiving nifedipine tocolysis. In a retrospective study design, twin pregnancies receiving outpatient preterm labor surveillance services and oral nifedipine tocolysis following a diagnosis of preterm labor were identified from a database ( N = 1421). Eligible for inclusion were patients subsequently rehospitalized with recurrent preterm labor symptoms ( N = 862).

Prophylaxis with 17 alpha-hydroxyprogesterone caproate for prevention of recurrent preterm delivery: does gestational age at initiation of treatment matter?

Objective: The purpose of this study was to determine effectiveness of 17 alpha-hydroxyprogesterone caproate (17 P) prophylaxis by gestational age (GA) at 17 P initiation.

Study Design: Singleton gestations with > or = 1 preterm birth (PTB) treated with 17 P prophylaxis for recurrent preterm birth before 27 weeks were identified from a data base. Data were stratified by GA at 17 P initiation (16-20.

Increased incidence of gestational diabetes in women receiving prophylactic 17alpha-hydroxyprogesterone caproate for prevention of recurrent preterm delivery.

Objective: Progesterone has a known diabetogenic effect. We sought to determine whether the incidence of gestational diabetes mellitus (GDM) is altered in women receiving weekly 17alpha-hydroxyprogesterone caproate (17P) prophylaxis for the prevention of recurrent preterm birth.

Research Design And Methods: Singleton gestations in women having a history of preterm delivery were identified from a database containing prospectively collected information from women receiving outpatient nursing services related to a high-risk pregnancy.

Gestational age at initiation of 17-hydroxyprogesterone caproate (17P) and recurrent preterm delivery.

Objective: To compare rates of recurrent preterm birth between women starting treatment with 17alpha-hydroxyprogesterone caproate (17P) at 16-20.9 weeks of gestation versus 21-26.9 weeks.

Increased recurrence of preterm delivery with early cessation of 17-alpha-hydroxyprogesterone caproate.

Objective: The purpose of this study was to identify the effect of early cessation of 17-alpha-hydroxyprogesterone caproate (17P) on the incidence of spontaneous recurrent preterm delivery (PTD).

Study Design: Retrospective analysis of data from women who were enrolled for outpatient 17P administration between January 2004 and May 2006 included women with previous PTD and current singleton pregnancy who were beginning weekly 17P injections (250 mg intramuscularly) at 16-20.9 weeks.

The impact of glycemic control on neonatal outcome in singleton pregnancies complicated by gestational diabetes.

Objective: To identify the impact of suboptimal blood glucose control on neonatal outcomes in women with gestational diabetes mellitus (GDM).

Research Design And Methods: Included were patients with singleton gestation enrolled in an outpatient GDM management program for at least 7 days who delivered at term. Blood glucose control was defined as an average fasting blood glucose of <95 mg/dl, 1-h postprandial of <140 mg/dl, or 2-h postprandial of <120 mg/dl.

Cost-savings analysis of an outpatient management program for women with pregnancy-related hypertensive conditions.

The aim of this study was to evaluate the cost savings of outpatient management services for women with pregnancy-related hypertensive conditions. The outpatient management program included verbal and written patient education related to the hypertensive disease process during pregnancy as well as self-care procedures. Biometric data (ie, automated blood pressure measurement, qualitative urine protein) were collected at least daily by the patient and transmitted telephonically to a nursing call center.

Excessive uterine contractions: effect on the incidence of preterm delivery in twin gestation.

Objective: To evaluate the effect of uterine contractions on the incidence of preterm delivery within 7 and 14 days in twin pregnancies.

Study Design: Study patients were identified from a large database composed of women receiving outpatient surveillance with home uterine contraction monitoring. We included tracings collected on a routine or acute basis from twin pregnancies without cerclage at 24.

A randomized multicenter study to determine the efficacy of activity restriction for preterm labor management in patients testing negative for fetal fibronectin.

Objective: To assess the impact of activity restriction (AR) on the incidence of preterm birth in women treated for preterm labor testing negative for fetal fibronectin (fFN).

Study Design: Women who were diagnosed with preterm labor and tocolyzed with magnesium sulfate were concurrently screened with fFN for the purpose of subsequent management. Included were consenting patients with negative fFN, gestational age 23 0/7-33 6/7 weeks, cervical dilation < or =3 cm, and minimal vaginal bleeding.

Consequences of nonindicated preterm delivery in singleton gestations.

Objective: To determine the neonatal and economic consequences of nonindicated preterm delivery in singleton gestations.

Study Design: From a database of women with high-risk pregnancies enrolled for outpatient nursing services between October 1995 and February 2000, singleton gestations with induced labor or scheduled cesarean delivery and a gestational age at delivery of 34-36 weeks were identified. Excluded were women with preterm premature rupture of the membranes or medically indicated delivery.

Managing perinatal outcomes: the clinical benefit and cost-effectiveness of pharmacologic treatment of recurrent preterm labor.

Purpose: To compare the clinical benefit and cost-effectiveness of utilizing continuous subcutaneous terbutaline versus oral tocolytics following recurrent preterm labor.

Design: Retrospective, 1:1 matched cohort.

Methodology: From prospectively collected data in a nationwide, perinatal database of women receiving outpatient services, we identified singleton gestations having recurrent preterm labor, stabilized during hospitalization, and subsequently treated with oral tocolytics (PO group) or continuous subcutaneous terbutaline infusion (SQ group).