Highlights
- •Pregnant women after abdominal trachelectomy (AT) were high risk at preterm birth.
- •Vaginal progesterone (VP) did not prevent preterm birth in women after AT.
- •Presence of uterine cervix is essential for preventive effects of VP on preterm birth.
Abstract
Objective
To determine whether vaginal progesterone (VP) reduces the rate of preterm birth in
pregnant women after abdominal trachelectomy (AT) for early-stage cervical cancer
Study Design
This is an interventional study with a historical cohort. For the interventional study
participants who had singleton pregnancies after AT between October 2016 and September
2020, the administration of vaginal progesterone was started between 16+ and 19+6 weeks of gestation and discontinued at 34 weeks of gestation or at the time of delivery,
rupture of membranes, or massive uterine bleeding. We investigated obstetric and neonatal
outcomes among the study participants and compared them with outcomes of the historical
control group participants, included women with singleton pregnancies after AT who
were managed without VP at our institution between January 2007 and September 2016,
using Fisher’s exact test and the Mann–Whitney U test The main outcomes were the gestational age at delivery and incidence of preterm
birth before 37 weeks and 34 weeks of gestation.
Result
Twelve pregnancies in ten women were included in the VP group. In contrast, 19 pregnancies
in 17 women were included in the historical control group. The incidence of preterm
birth at <37 weeks was 10/12 (83 %) in the VP group and 11/19 (58 %) in the control
group. The incidence of preterm birth at <34 weeks was 6/12 (50 %) in the VP group
and 9/19 (48 %) in the control group. The incidence of preterm birth in the two groups
was similar, and the difference between the two groups was not statistically significant.
Conclusion
The administration of vaginal progesterone did not reduce the rate of preterm birth
among pregnant women after AT.
Keywords
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Article info
Publication history
Published online: February 13, 2021
Accepted:
February 10,
2021
Received in revised form:
February 8,
2021
Received:
December 17,
2020
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
