Name of the Procedure:

Injection, Hydroxyprogesterone Caproate, 1 mg (J1725)

Common Name(s):

• Hydroxyprogesterone injection
• Makena (brand name)

Technical or Medical Terms:

• Hydroxyprogesterone caproate

Summary

Hydroxyprogesterone caproate injection is a medical procedure where a hormone is administered via injection to help prevent preterm birth in pregnant women who have had a previous spontaneous preterm birth.

Purpose

The primary purpose of this injection is to reduce the risk of having a preterm birth, which can pose significant health risks to both the mother and the baby. By administering this hormone, the protocol aims to maintain a stable pregnancy closer to the full term.

Indications

• History of spontaneous preterm birth (delivery before 37 weeks of pregnancy)
• Single fetus pregnancy (not twins or multiples)
• Absence of other preterm labor contraindications

Preparation

• No specific fasting required.
• Avoid certain medications as advised by your healthcare provider.
• A pelvic exam and ultrasound might be performed to assess the pregnancy.

Procedure Description

1. The patient will be asked to lie down in a comfortable position.
2. A healthcare professional will clean the injection site, commonly the upper quadrant of the buttock.
3. Using a sterile syringe, the healthcare provider will inject 1 mg of hydroxyprogesterone caproate into the muscle.
4. The injection process takes a few minutes, followed by observation for any immediate reactions.

Tools Used:

• Sterile syringe and needle
• Hydroxyprogesterone caproate solution

Anesthesia:

• Not typically required, although a topical anesthetic may be used to numb the injection site if needed.

Duration

The injection itself takes about 5-10 minutes.

Setting

The procedure is performed in a clinical setting such as an outpatient clinic or a hospital.

Personnel

• Licensed healthcare providers such as nurses, nurse practitioners, or physicians.

Risks and Complications

Common Risks:

• Pain or swelling at the injection site
• Mild allergic reactions

Rare Risks:

• Severe allergic reactions
• Blood clots
• Increased blood pressure

Management of Complications:

• Immediate medical attention for severe reactions or clots.
• Pain management protocols for injection site discomfort.

Benefits

• Reduces the risk of preterm birth.
• Improves outcomes for both mother and baby.
• Benefits usually realized as the pregnancy progresses and reaches closer to full term.

Recovery

• Most patients can resume normal activities immediately.
• Patients are advised to monitor for any adverse reactions at the injection site.
• Follow-up appointments may be scheduled weekly to monitor the pregnancy and administer subsequent doses.

Alternatives

• Cervical cerclage (surgical procedure to close the cervix)
• Lifestyle modifications to reduce preterm labor risks
• Bed rest, although its effectiveness is debated

Pros and Cons:

• Hydroxyprogesterone injection is less invasive compared to surgical options.
• Lifestyle modifications are non-invasive but may not be as effective in high-risk cases.

Patient Experience

During the Procedure:

• Mild discomfort or pain at the injection site.

After the Procedure:

• Temporary soreness or swelling.
• Pain management can involve the use of over-the-counter pain relief medications.

Comfort Measures:

• Applying ice to the injection site.
• Wearing loose-fitting clothing to avoid pressure on the injection area.