When does 17P help?

[LM96]

My son was born at 36 weeks due to PROM and my daughter was born at 29 weeks due to a placental abruption. When I went for my annual physical a few weeks ago, my midwife mentioned that progesterone shots may be beneficial if I get pregnant again. However, the articles I have seen on the web always seem to mention a shortening of the cervix which I don't believe was the primary cause of either of my premature babies. Does anyone know of any sites that might help me determine if 17P would be helpful for me or not?

[sbrinton]

I think 17P works best when the previous premature birth was due to preterm labor - contractions leading to cervical change. From what I understand, the 17P may work to help relax the uterus and prevent preterm labor in maybe 30% of women who are high-risk to have a second preterm birth.

Did you have preterm labor contractions with either of your earlier pregnancies? If not, I'd be skeptical of 17P.

We decided not to do 17P with our third and he was born prematurely. Maybe we would have gone further if we got the shots, but our peri felt like there isn't solid enough long term research on the safety of 17P.

[irangel]

My understanding is that the 17P shots help to relax the uterus to prevent pre-term labor which in turn dilates and effaces the cervix. I was given them with my 3rd pregnancy because my second pregnancy ended at 29wks due to pre-term labor and pPROM. My third pregnancy ended at 25wks due to partial placental abruption that caused me to go into PTL and rupture.

[LM96]

With my first, I started leaking and didn't have any contractions for several hours. With my 2nd, I started bleeding @ 29 weeks due to a placental abruption and was in the hospital for 3 days before I had contractions that couldn't be stopped. Both times, I had other events that caused the contractions, so it looks like progesterone wouldn't be all that helpful for me which goes with what I have read so far in the 'net. Thanks.

[amydiane]

I grilled one of my high-risk OBs about this because they were pretty strongly recommending it with this pregnancy. I had a placental abruption, then PPROM, then preterm labor with my DS. I also came to the conclusion that since I had an event that caused the PTL, it didn't seem like 17P would be helpful. However, when I asked the OB about this, she said there were new guidelines from AGOC that said that it could be helpful if your PTL was caused by PROM. Unfortunately I didn't get any info on why they now think this, so I don't know if there are new studies or what. Just wanted to let you know that and maybe you will be more successful finding info than I was.

[sunflowers]

I had an IC and a cerclage with my dd. My doc prescibed the 17p to reduce the risk of preterm contractions from destroying the cerclage. I gave birth at 27w after my cerclage failed at 26w. So while technically pPROM was the cause of my preterm births, the pPROM was a result of IC.

I don't know if the 17p helped but I was glad I did them. I never heard of any risks associated with the drug.

[susienjay]

With my Perinatologist group there are 3 doctors and 2 of them recommend the shots and the other one doesn't. One of the OBs in the practice I used last pregnancy called them "snake oil". My insurance approved the shots with no problems at all. With 2 premature births I even got a case manager when they approved the shots.

My first premature birth was due to cervical shortening (but I was having twins and cervical shortening is more common with twins). The second was an abruption. I did the P17 shots with the next pregnancy and my son was born 8 days before his due date. I'm not sure if that is what made the difference but I'd probably do them again if we have another baby.

I did 19 shots in all and the first 10-12 weren't too bad. The last few were really hard because my rear end was so sore. I had one shot I seemed to have a reaction to and I couldn't sit on that side for several days afterwards. Matria came out to my house to do the shots which was the best part of them. I didn't have to drag my older kids out every week for a shot.

I was actually more scared about another abruption than anything. My Peri said the risk is 10% if you've already had one. I have none of the risk factors for abruption though other than already having one.