PubMed Central:

Introduction

Threatened miscarriage is a common disease during early pregnancy, with a morbidity of 30% to 40%, which could develop into a complete miscarriage or dystocia without timely treatment. Many pathogenic factors contribute to the threatened miscarriage, of which lacking progestogens due to the endocrine dysfunction of corpus luteum is one of the main culprits.

Therefore, supplementation of progestogens is a primary therapeutic strategy for the treatment of threatened miscarriage due to corpus luteum insufficiency, among which progesterone and dydrogesterone are the leading medications in clinical practice.

In this study, authors designed a prospective cohort study to compare the effect of droprogesterone and progesterone in the treatment of threatened miscarriage due to corpus luteum insufficiency.

Take Home Message:

In this study, serum sex hormone levels were elevated and the preterm birth rate was significantly reduced in patients treated with dydrogesterone. Also reported that dydrogesterone could effectively reduce the preterm birth rate.

In addition, the rate of postpartum hemorrhage and adverse effects were significantly reduced in the dydrogesterone group of this study. Other studies have also demonstrated that dydrogesterone could effectively reduce the incidence of hypertension and preeclampsia during pregnancy, which may be one of the mechanisms by which dydrogesterone could reduce the incidence of preterm birth and postpartum hemorrhage.

Compared with progesterone soft capsules, the advantages of dydrogesterone in the treatment of patients with threatened miscarriage due to corpus luteum insufficiency include:

① As a progesterone analog, dydrogesterone can be quickly absorbed via oral administration, and has a higher affinity and specificity for progesterone receptors;

② It can be orally administered, with few adverse effects and higher medication compliance;

③ It demonstrates a good immunomodulatory effect, effectively reduces maternal immune response to embryos, and promotes embryo implantation;

④ It can inhibit the synthesis and release of prostaglandins in the endometrium and provide a favorable environment for embryo development.

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