Hydroxyprogesterone caproate

Hydroxyprogesterone caproate (OHPC) is a synthetic progestin medication used in the prevention of preterm birth in pregnant women with a history of at least one spontaneous preterm birth. It is also used in the treatment of gynecological disorders and certain types of cancer. OHPC is administered via intramuscular injection.

Medical Uses

OHPC is primarily used to reduce the risk of preterm birth in women with a singleton pregnancy who have a history of singleton spontaneous preterm birth. The American College of Obstetricians and Gynecologists (ACOG) recommends the use of OHPC as a preventive treatment starting from 16 to 20 weeks of gestation until 36 weeks of gestation in these women.

In addition to its use in obstetrics, OHPC has been used in the treatment of gynecological disorders such as endometriosis, amenorrhea, and abnormal uterine bleeding. It is also utilized in hormone therapy for transgender women and in the treatment of certain cancers, including prostate cancer and endometrial cancer, as part of palliative care.

Mechanism of Action

OHPC acts by mimicking the action of the natural hormone progesterone, which is essential for maintaining pregnancy. Progesterone works by suppressing the maternal immune response to prevent rejection of the embryo, reducing the contractility of the uterus to decrease the likelihood of preterm contractions, and supporting the endometrial lining to facilitate implantation and growth of the embryo. OHPC's exact mechanism in preventing preterm birth is not fully understood but is believed to involve these progesterone-mediated processes.

Side Effects

The use of OHPC can be associated with several side effects, including injection site reactions (pain, swelling, itching, and bruising), nausea, diarrhea, and hives. More serious side effects may include depression, jaundice, and hypertension. Pregnant women receiving OHPC should be monitored for signs of these adverse effects.

Pharmacology

OHPC is a long-acting ester of hydroxyprogesterone. After intramuscular injection, it is slowly released into the bloodstream, providing a sustained level of the hormone. Its long half-life allows for once-weekly dosing, which is convenient for patients.

History

Hydroxyprogesterone caproate was first synthesized in the 1950s and has been used for various medical applications since then. Its role in preventing preterm birth has been the subject of research and clinical trials, leading to its endorsement by medical organizations for this use.

Controversies

The use of OHPC has been subject to debate, particularly regarding its effectiveness in preventing preterm birth in different populations and its cost-effectiveness. Some studies have shown significant benefits, while others have called its efficacy into question. The discussion continues as further research is conducted to clarify its role in obstetric care.

See Also

• Progesterone
• Preterm birth
• Progestin
• Gynecology
• Obstetrics