Discuss the use of progesterone therapy as an IMR intervention
Progesterone therapy was selected as the downstream intervention in Montgomery County. Progesterone is a hormone that plays an important role in maintaining pregnancy. When given to appropriately screened pregnant women, progesterone therapy reduces the rate of recurrent preterm deliveries in women with a prior preterm birth. Progesterone therapy also reduces the rate of preterm births in women diagnosed with a short cervix at ultrasound. The behavioral target of the progesterone therapy intervention was to increase the percentage of pregnant women who adhere to the prescribed progesterone therapy. Once identified as eligible, treatment adherence involved weekly injections for the women with prior preterm birth or daily vaginal suppositories for women with a diagnosis of short cervix. Primary activities of the progesterone therapy intervention included screening and identifying at-risk pregnant women, prescribing and filling progesterone prescriptions, encouraging adherence with the treatment, and following up with the patient. Screening for progesterone eligibility was done via a standardized clinical algorithm.?
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