Preterm Birth Prevention with Progesterone

Clinical Guidelines for Progesterone Administration

• The American College of Obstetricians and Gynecologists recommends 17-hydroxyprogesterone caproate (17P) 250 mg IM weekly from 16-20 weeks until 36 weeks for women with prior spontaneous preterm birth, based on stronger evidence of effectiveness compared to other progesterone preparations 1, 2.
• For women without prior preterm birth but with short cervical length ≤20 mm, vaginal progesterone (90 mg gel or 200 mg suppository) daily is recommended, not IM progesterone, as stated by the American College of Obstetricians and Gynecologists 1, 4.
• The American College of Obstetricians and Gynecologists does not support interchangeability between routes for preterm birth prevention, with IM 17P being the evidence-based standard for women with prior spontaneous preterm birth 1, 3.