At what gestational age should 17α-hydroxyprogesterone caproate injection therapy be initiated?

The initiation of 17α-hydroxyprogesterone caproate injection therapy is most appropriately recommended between 16-20 weeks of gestation and continued until 37 weeks. This treatment is specifically aimed at reducing the risk of preterm birth in women who have a history of spontaneous preterm birth. The timing is crucial, as starting the therapy too early or too late can compromise its effectiveness. By initiating the injections in the 16-20 week window, providers can ensure that the medication is administered during a critical period when it has been shown to impact cervical stability and uterine activity, thereby potentially extending gestation.

In contrast, starting treatment as soon as pregnancy is diagnosed may not be beneficial, since the majority of preterm births occur later in the pregnancy. This makes the option of beginning treatment early in pregnancy less effective than the recommended gestational window. Establishing treatment at 12-14 weeks is also outside the recommended range and does not take into account the timing when the most significant benefits can be achieved. Administering the medication only during labor does not provide the preventive benefits that this therapy is known for, as it is not designed to address preterm birth risk at that stage. Thus, the correct timing for administration significantly