Progesterone maintains pregnancy by enhancing uterine quiescence. During early pregnancy, the syncytiotrophoblast secretes human chorionic gonadotropin (hCG), which stimulates progesterone production in the corpus luteum by preventing regression of this tissue.

Low serum hCG or progesterone levels may predict first trimester abortions. During early pregnancy in women with threatened abortion, progesterone levels were lower in those who had a subsequent miscarriage than in those whose pregnancies continued to fetal viability. Moreover, progesterone receptor antagonists may induce abortion or labor by increasing myometrial contractility and excitability throughout pregnancy.

Threatened abortion, which occurs in 20% of all pregnancies, is diagnosed when vaginal bleeding with or without abdominal pain occurs during the first half of pregnancy. The required prerequisites for threatened abortion are a closed cervix and an intrauterine viable fetus. Unfortunately, nearly half of threatened abortions end in miscarriage.

TAKE HOME MESSAGE:

In this study, using an updated systematic analysis, authors aimed to evaluate the effectiveness of progesterone therapy delivered via different administration routes for preventing miscarriages in pregnant women with threatened abortion.

In this meta-analysis, authors demonstrated that progesterone therapy may be effective in preventing miscarriages in pregnant women with threatened abortion.

In particular, oral Dydrogesterone prevented miscarriage in pregnant women more effectively than the control-treated groups (placebo or conservative treatment), although there was no difference between oral and vaginal progestational agents in preventing miscarriages in pregnant women experiencing threatened abortion.

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