Algorithm for Consideration of the Use of Progestins for Reducing the Risk of Preterm Birth (PTB)

Algorithm for Consideration of the Use of Progestins for Reducing the Risk of Preterm Birth (PTB)

Algorithm for Consideration of the Use of Progestins for Reducing the Risk of Preterm Birth (PTB) - Flowchart

«Flowchart»

Singletons

Singletons

Singletons

Prior PTB

Prior PTB

Prior PTB

No prior PTB

No prior PTB

No prior PTB

End

End

End

Routine obstetric care

Routine obstetric care

Routine obstetric care

17-P^b

17-P^b

17-P^b

^b b

Continue 17-P

Continue 17-P

Continue 17-P

Cerclage; continue 17-P

Cerclage; continue 17-P

Cerclage; continue 17-P

Serial TVU CL at 16–23 6/7 wk

Serial TVU CL at 16–23 6/7 wk

Serial TVU CL at 16–23 6/7 wk

CL < 25 mm

CL < 25 mm

CL < 25 mm

CL >=25 mm

CL >=25 mm

CL >=25 mm

Vaginal progesterone^c

Vaginal progesterone^c

Vaginal progesterone^c

^c c

^a If transvaginal ultrasound (TVU) cervical length (CL) screening is performed.

^a If transvaginal ultrasound (TVU) cervical length (CL) screening is performed.

^a If transvaginal ultrasound (TVU) cervical length (CL) screening is performed.

^a

^b 17-!!alpha!! hydroxyprogesterone caproate (17-P) 250 mg intramuscularly every week from 16-20 to 36 weeks, if selected weighing the risk and benefits of research to late discussed on the prior page.

^b 17-!!alpha!! hydroxyprogesterone caproate (17-P) 250 mg intramuscularly every week from 16-20 to 36 weeks, if selected weighing the risk and benefits of research to late discussed on the prior page.

^b 17-!!alpha!! hydroxyprogesterone caproate (17-P) 250 mg intramuscularly every week from 16-20 to 36 weeks, if selected weighing the risk and benefits of research to late discussed on the prior page.

^b

^c For example, daily 200-mg suppository or 90-mg gel from time of diagnosis of short CL to 36 weeks.

^c For example, daily 200-mg suppository or 90-mg gel from time of diagnosis of short CL to 36 weeks.

^c For example, daily 200-mg suppository or 90-mg gel from time of diagnosis of short CL to 36 weeks.

^c

Single TVU CL at 18–24 wk^a

Single TVU CL at 18–24 wk^a

Single TVU CL at 18–24 wk^a

^a a

CL <=20 mm

CL <=20 mm

CL < =20 mm

CL >20 mm

CL >20 mm

CL >20 mm