OB-GYN-L Messages for December, 2005: Re: 17P- Controversy

Re: 17P- Controversy

From: Andrew Folley

agfolley@hotmail.com

Wed Dec 7 13:17:51 2005

The controversy lies in the original study by Meis in the 90's. Their hypothesis was that in the select group of pts with a history of pre term birth, if you give them 17OHP weekly etc would it reduce their risk of having the next baby prematurely. That risk is known to be about 30-35% right?

The study showed that the placebo group of pts had a premautrity risk of about 50% and the treatment group had a preterm delivery risk of about 30-35%. The conclusion was the 17OHP IM 250mg weekly reduced the preterm rate by 1/3 in high risk patients.

The contorversy and question is did it do anything at all or was the placebo group being adversely effected by the placebo. Interestingly enough, the placebo was castor oil give IM monthly. Do you see the problem. The treatment group came out with a 35% chance of delivering prematurely which is the same as the background group of high risk patients with a history of previous preterm birth.

There is a new study in the works being done by Creasy looking at the effect of 17OHP gel (Prochief) given vaginally daily at 20 weeks onward. andy >From: "AFuentes" <afuentes@mindspring.com>
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: RE: 17P
>Date: Wed, 7 Dec 2005 10:53:00 -0600
>
>What is the controversy? I haven't come across any issues with the Meis
>study. Can you fill me in?
>
>Thanks
>Armando Fuentes, MD
>Maternal Fetal Ctr
>Winter Park, FL
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Andrew
>Folley
>Sent: Wednesday, December 07, 2005 8:36 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: RE: 17P
>
>Some controversy exists as to whether it works at all. Qustions regarding
>Meis original studyies. New research going on for use of 17 OH cream in
>vagina. andy
>
> >From: ainsron@sbcglobal.net (Dr. Ainsworth)
> >Reply-To: ob-gyn-l@obgyn.net
> >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
> >Subject: 17P
> >Date: Tue, 6 Dec 2005 23:52:15 -0600
> >
> >For those of you using or considering 17P for patients with Hx of
> >preterm labor, How would you use it in which of the following
> >circumstances?:
> >
> >1. 25 yo G3 P1102, history of first pregnancy at 40 wks, no
> >complications, no PTL; second pregnancy at 36 weeks, PROM, followed by
> >spontaneous labor.
> >
> >2. 25 yo G3 P1102, history of first pregnancy complicated by PTL from
> >30 weeks; delivery at 35 weeks, second pregnancy delivery at 39 weeks,
> >no PTL, not given 17P.
> >
> >3. 25 yo G3 P1102, history of term delivery at 39 weeks; second
> >pregnancy PTL from 30 weeks, delivery at 36 weeks.
> >
> >4. 25 yo G3 P2002, history of term delivery at 39 weeks; second
> >pregnancy PTL from 30 weeks, delivery at 39 weeks.
> >
>
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