Clinical Expert Series
Identification of Candidates for Progesterone: Why, Who, How, and When?
Jay D. Iams, MD
Obstet Gynecol 2014;123:1317–26
Continuing Medical Education credit is provided through joint sponsorship with
The American College of Obstetricians and Gynecologists.
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Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
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Category 1 Credits.™ Physicians should claim only the credit commensurate with the extent of their participation in the activity.
College Cognate Credit(s)
The American College of Obstetricians and Gynecologists designates this enduring material for a maximum of 2 Category 1
College Cognate Credits. The College has a reciprocity agreement with the AMA that allows AMA PRA Category 1 Credits™ to be
equivalent to College Cognate Credits.
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Submission
Before submitting this form, please print a completed copy as confirmation of your program participation.
College Fellows: To obtain credits, complete and return this form by e-mail (obgyn@greenjournal.org) or fax (202-479-0830).
Your score, and a copy of the answer key, will be e-mailed to you after receipt of a completed quiz. Credit will be recorded for
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Non–College Fellows: To obtain credits, submit the printout of the completed quiz to your accrediting institution. The printout of
the completed quiz is documentation for your continuing medical education credits.
Continuing medical education credit for “Identification of Candidates for Progesterone: Why, Who, How, and When?” will be
available through June 2017.
1. The author asserts that responsibility for the prevention of death from preterm birth is now in the
hands of:
State health departments
The federal government
Obstetrician–gynecologists
Perinatologists
Pediatricians
CME Quiz for the Clinical Expert Series
Obstet Gynecol 2014;123(6)
Credit available through June 2017
Page 1 of 3
2. The greatest contributor to overall infant mortality is:
Septicemia
Maternal drug addiction
Prematurity
Parental abuse
Sudden infant death syndrome (SIDS)
3. The greatest impediment to implementing the results of research regarding the use of progesterone to
delay delivery is:
Lack of insurance funding
Conflicting guidelines for different sources
Uncertainty about how to implement guidelines
Patient resistance to treatment
Cost of treatment
4. Which of the following patients would be a candidate for vaginal progesterone therapy?
A patient with a history of a stillbirth at 37 weeks of gestation considering pregnancy
A patient currently at 12 weeks of gestation with a history of two prior deliveries at 32
weeks and 28 weeks
A patient with a cervical length of 18 mm at 20 weeks of gestation
A patient with a cervical length of 26 mm at 22 weeks of gestation
A patient with a cervical length of 12 mm at 30 weeks of gestation
5. The author asserts that the optimal gestational age for the initiation of indicated 17αhydroxyprogesterone caproate prophylaxis is:
8–10 weeks
12–15 weeks
16–20 weeks
21–25 weeks
26–30 weeks
6. Women with a prior preterm birth receiving 17α-hydroxyprogesterone caproate whose cervical length
falls below 25 mm before 23 weeks are candidates for:
Dose escalation
Conversion to vaginal progestin therapy
Cervical cerclage
Continued monitoring
Immediate delivery
CME Quiz for the Clinical Expert Series
Obstet Gynecol 2014;123(6)
Credit available through June 2017
Page 2 of 3
7. The first step in the author’s proposed algorithm for identifying patients who might benefit from
progestin therapy is:
Past obstetric history
Family history
Transabdominal ultrasonographic measurement of cervical length
Transvaginal ultrasonographic measurement of cervical length
Review of current symptoms
8. The highest rate of preterm birth occurs in women who are:
Caucasian
Asian
Black (African American and Afro-Caribbean)
Hispanic
American Indian
9. A “screening out” approach to limiting the number of cervical length measures performed would
include such factors as:
Race
Maternal age
Paternal age
Past obstetric history
Social disadvantage
10. What is the proposed threshold cervical length to initiate progesterone treatment?
10 mm
15 mm
20 mm
25 mm
30 mm
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CME Quiz for the Clinical Expert Series
Obstet Gynecol 2014;123(6)
Credit available through June 2017
Page 3 of 3