Objective: to study the effectiveness of hydroxyprogesterone caproate in high risk cases for preterm labour.
Study Design: observational study.
Place and Duration of Study: January 2014-December 2014, Obs/Gynae ward, PAF Hospital Islamabad.
Methodology: the study included fifty seven patients who were high risk for preterm labour and were admitted at obs/gyne ward at PAF hospital Islamabad. They had gestational amenorrhea between 24 – 34 weeks and complaints of pain lower abdomen/ uterine contractions/vaginal infection /urinary infection/previous history of preterm labour/irritable uterus or cervical length less than 3.0 cm. They were treated with hydroxyprogesterone injections once weekly along with protocol of preterm labour. The effects of injection hydroxyprogesterone caproate were studied and patients were followed till delivery. The results were presented in tabulated form.
Results: a total of 57 patients were screened as being high risk for preterm birth. Among them 22 (38.59%) patients were found to have history of one or more preterm deliveries before. Cervical length less than 3.5 cm was calculated in 9(15.78%) women. Among 57 women 37(64.91%) were from low socioeconomic class. Only 5(8.77%) women were tobacco smokers. Irritable uterus was observed in 41(71.92%) of patients. Most of the patients were anemic. Vaginal, Urinary tract and gingival infection was observed in 21(36.845%), 19(33.33%) and 15(26.31%) women respectively.
After empirical treatment of preterm labour and Progesterone supplementation pain lower abdomen was improved in 29 (68.42%) patients. Feeling of uterine contractions was improved in 26(81.25%) patients. Backache was better in 16(64%) women. Similarly there was marked improvement in vaginal discharge and urinary symptoms.
Out of 57 women 5(8.77%) delivered at 24-27+6, 7(12.28%) at 28-31+6 weeks of gestation and 32(56.14%) reached 32-36+6 weeks gestation while 13(2.80%) patients reached term.      
Conclusion: control of preterm birth is a challenging event for the obstetrician. The use of natural progesterone in the form of hydroxyprogesterone caproate injections in women who are high risk for preterm birth results in marked reduction in preterm birth
Key Words: preterm labour, threatened preterm labour, cervical length, hydroxyprogesterone caproate.

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