Name of the Procedure:

Hydroxyprogesterone, 17-d (also known as 17 alpha-hydroxyprogesterone caproate or 17-OHPC)

Summary

Hydroxyprogesterone, specifically 17-d, is a hormone injection used to reduce the risk of preterm birth in women who have had a previous preterm delivery. It helps maintain pregnancy by preventing contractions and maintaining the uterine lining.

Purpose

• Medical Condition: Used to lower the risk of recurrent preterm birth in women who are pregnant with a singleton baby and have had a spontaneous preterm delivery in the past.
• Goals/Expected Outcomes: The primary goal is to lengthen pregnancy, reducing the risk of premature birth and its associated complications for the infant.

Indications

• Women with a history of spontaneous preterm birth.
• Pregnant women carrying a singleton (one baby).
• Administered typically from the second trimester (16-20 weeks) through 37 weeks of gestation or until delivery.

Preparation

• Pre-procedure Instructions: No special preparation is generally required for the patient.
• Diagnostic Tests: Physician may review pregnancy history and confirm the absence of multiple gestations (twins, triplets, etc.).

Procedure Description

1. Administration: The procedure involves a weekly injection of 17-OHPC.
2. Injection Site: The injection is usually given in the upper outer quadrant of the buttock.
3. Medication: A specific dose of 250 mg/mL of 17-OHPC is administered.
4. Maintenance: The injections are continued weekly until the 37th week of pregnancy or delivery.

Duration

• Each injection takes only a few minutes to administer.
• The full course lasts from around week 16-20 of pregnancy until 37 weeks or delivery.

Setting

• Typically performed in an outpatient clinic, doctor's office, or at home if supervised by a healthcare provider.

Personnel

• Administered by a trained healthcare provider, which could be a nurse or doctor.

Risks and Complications

• Common Risks: Pain, swelling, itching, or bruising at the injection site.
• Rare Risks: Allergic reactions, blood clots, or fluid retention.
• Management: Any adverse effects should be promptly reported and managed by a healthcare provider.

Benefits

• Expected Benefits: Significant reduction in the risk of recurrent preterm birth.
• Timeline: Benefits are realized as the pregnancy progresses, with the goal of reaching full-term gestation.

Recovery

• Post-Procedure Care: Minimal post-procedure care; monitor for any injection site reactions.
• Recovery Time: No downtime required; patients can resume normal activities immediately.
• Follow-Up: Regular prenatal visits to monitor pregnancy progress.

Alternatives

• Other Treatments: Lifestyle modifications, other medications to manage preterm labor symptoms.
• Comparison: Alternatives may not be as effective in reducing the risk of preterm birth for those with a history of spontaneous preterm delivery.

Patient Experience

• During Procedure: Mild discomfort or pain during the injection.
• After Procedure: Possible soreness at the injection site; most patients find it manageable with standard pain relief measures if necessary.

By providing this hormone injection, healthcare providers aim to give pregnant women the best chance of carrying their babies to full term, significantly reducing the risks associated with preterm birth.