Efficacy of progesterone on threatened miscarriage: Difference in drug types
The Journal of Obstetric and Gynecological Research:
Miscarriage is the most common cause of early pregnancy loss in the first 24 weeks and one of the most common complications in early pregnancy. An estimated 15% to 20% of pregnancies will end in a miscarriage, with 25% of women experiencing a miscarriage in their lifetime. Women can be at risk of a miscarriage if they experience early pregnancy bleeding, or if they have a history of previous miscarriages.
Progesterone is an important pregnancy hormone that helps to maintain a pregnancy. A variety of different progesterone-like treatments (known as progestogens) have been used to treat women with early pregnancy bleeding. They are also used to prevent miscarriage in women with a history of previous miscarriages.
Two important clinical risk factors for miscarriage are a history of previous miscarriages and vaginal bleeding in early pregnancy. Progesterone supplementation has therefore been attempted to prevent miscarriages in asymptomatic women with a history of miscarriages and in women who have started to bleed in early pregnancy.
The aim of the study is to investigate whether treatment with progesterone would decrease the incidence of miscarriage in women who faced threatened miscarriage.
This study findings show that progesterone agents are effective in reducing the incidence of miscarriage in threatened miscarriage. Dydrogesterone, was associated with a lower risk of miscarriage.
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Aim: To investigate whether treatment with progesterone would decrease the incidence of miscarriage in women who faced threatened miscarriage.
Methods: Randomized controlled trials (RCT) were identified by searching PubMed, Embase, Cochrane Library and Web of Science. Trials were included if they compared progesterone with placebo, no treatment or any other treatment given in an effort to treat threatened miscarriage. Pregnant prophylaxis drugs were not included without strict progesterone type, language and progesterone management. The primary outcome was the incidence of miscarriage. The summary measures were reported as relative risk (RR) with 95% confidence interval (CI).
Results: Eight RCT including 845 women who faced threatened miscarriage were analyzed. Pooled data from the eight trials showed that women with threatened miscarriage who were randomized to the progesterone group had a lower risk of threatened miscarriage. Dydrogesterone was shown to have a lower risk of miscarriage than natural progesterone. Oral management was demonstrated to have a lower risk of miscarriage  compared with vaginal administration.
Conclusion: Our findings show that progesterone agents are effective in reducing the incidence of miscarriage in threatened miscarriage. Dydrogesterone, but not natural progesterone, was associated with a lower risk of miscarriage.
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