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2020•Pakistan Postgraduate Medical JournalOpen access

ROLE OF VAGINAL PROGESTERONE IN THE PREVENTION OF PRETERM DELIVERY

Mehwish Illyas, Muhammad Zafar, Amna Shahid, Shabnam Tariq, Naila Yasmeen, Kamran Qureshi

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Abstract

BACKGROUND Preterm Birth is the main cause of Perinatal morbidity and Mortality. Progesterone has been used for preventing Preterm Labour and is being advocated for it. Its use in women presenting with Preterm labor pains has diverse results.The administration of Progesterone has been shown to lower not only the number of the episodes of preterm Uterine contractions but it also decrease the incidence of preterm delivery in the high risk women for Preterm delivery. OBJECTIVE To compare the frequency of Spontaneous Preterm Birth , in the woman having a prior history of one spontaneous Preterm Delivery, who are treated by 100mg of vaginal progesterone pessary daily versus controls. STUDY DESIGN A Randomized controlled trial was carried out at the Obstetrics & Gynaecology Department of Lahore General Hospital (a tertiary care hospital) of 6 months duration from 1-09-2018 To 28-02-2019. Two groups of Patients were made. Patients in Group-A were instructed to use a vaginal pessary containing 100mg natural progesterone daily before going to sleep every night, starting from the time of enrollment to 36 weeks of pregnancy or until occurrence of preterm labor or premature rupture of membranes. Patients in Group-B did not receive progesterone pessary and acted as control.All the patient were followed up until the delivery. RESULTS In Group :A and in Group:B mean age of the women was 27.71±3.31 and 27.81±3.57 years. There were total 60(30%) neonates who were delivered premature. In Group-A, the frequency of preterm delivery was 21%(21/100), while in Group-B it was 39%. The frequency of the Preterm delivery was quite significantly less in the women who were on progesterone as compared to the women who were not given progesterone. i.e. (p-value=0.005) CONCLUSION It is thus concluded that vaginal progesterone resulted in Significant reduction of the Preterm delivery rate in the women with a prior history of 1 spontaneous Preterm birth i.e. 21% in treatment group A vs. 39% in non-treatment group B.

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BACKGROUND Preterm Birth is the main cause of Perinatal morbidity and Mortality. Progesterone has been used for preventing Preterm Labour and is being advocated for it. Its use in women presenting with Preterm labor pains has diverse results.The administration of Progesterone has been shown to lower not only the number of the episodes of preterm Uterine contractions but it also decrease the incidence of preterm delivery in the high risk women for Preterm delivery. OBJECTIVE To compare the frequency of Spontaneous Preterm Birth , in the woman having a prior history of one spontaneous Preterm Delivery, who are treated by 100mg of vaginal progesterone pessary daily versus controls. STUDY DESIGN A Randomized controlled trial was carried out at the Obstetrics & Gynaecology Department of Lahore General Hospital (a tertiary care hospital) of 6 months duration from 1-09-2018 To 28-02-2019. Two groups of Patients were made. Patients in Group-A were instructed to use a vaginal pessary containing 100mg natural progesterone daily before going to sleep every night, starting from the time of enrollment to 36 weeks of pregnancy or until occurrence of preterm labor or premature rupture of membranes. Patients in Group-B did not receive progesterone pessary and acted as control.All the patient were followed up until the delivery. RESULTS In Group :A and in Group:B mean age of the women was 27.71±3.31 and 27.81±3.57 years. There were total 60(30%) neonates who were delivered premature. In Group-A, the frequency of preterm delivery was 21%(21/100), while in Group-B it was 39%. The frequency of the Preterm delivery was quite significantly less in the women who were on progesterone as compared to the women who were not given progesterone. i.e. (p-value=0.005) CONCLUSION It is thus concluded that vaginal progesterone resulted in Significant reduction of the Preterm delivery rate in the women with a prior history of 1 spontaneous Preterm birth i.e. 21% in treatment group A vs. 39% in non-treatment group B.

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Available abstract

BACKGROUND Preterm Birth is the main cause of Perinatal morbidity and Mortality. Progesterone has been used for preventing Preterm Labour and is being advocated for it. Its use in women presenting with Preterm labor pains has diverse results.The administration of Progesterone has been shown to lower not only the number of the episodes of preterm Uterine contractions but it also decrease the incidence of preterm delivery in the high risk women for Preterm delivery. OBJECTIVE To compare the frequency of Spontaneous Preterm Birth , in the woman having a prior history of one spontaneous Preterm Delivery, who are treated by 100mg of vaginal progesterone pessary daily versus controls. STUDY DESIGN A Randomized controlled trial was carried out at the Obstetrics & Gynaecology Department of Lahore General Hospital (a tertiary care hospital) of 6 months duration from 1-09-2018 To 28-02-2019. Two groups of Patients were made. Patients in Group-A were instructed to use a vaginal pessary containing 100mg natural progesterone daily before going to sleep every night, starting from the time of enrollment to 36 weeks of pregnancy or until occurrence of preterm labor or premature rupture of membranes. Patients in Group-B did not receive progesterone pessary and acted as control.All the patient were followed up until the delivery. RESULTS In Group :A and in Group:B mean age of the women was 27.71±3.31 and 27.81±3.57 years. There were total 60(30%) neonates who were delivered premature. In Group-A, the frequency of preterm delivery was 21%(21/100), while in Group-B it was 39%. The frequency of the Preterm delivery was quite significantly less in the women who were on progesterone as compared to the women who were not given progesterone. i.e. (p-value=0.005) CONCLUSION It is thus concluded that vaginal progesterone resulted in Significant reduction of the Preterm delivery rate in the women with a prior history of 1 spontaneous Preterm birth i.e. 21% in treatment group A vs. 39% in non-treatment group B.

Key concepts: Pessary, Medicine, Obstetrics, Randomized controlled trial, Pregnancy, Obstetrics and gynaecology, Premature rupture of membranes, Incidence (geometry)

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ROLE OF VAGINAL PROGESTERONE IN THE PREVENTION OF PRETERM DELIVERY — Research Paper | ScholarLens