TITLE:
Role of Vaginal Progesterone in Prevention of Preterm Labor in Women with Previous History of One or More Previous Preterm Births
AUTHORS:
Ahmed Mahmoud Abdou
KEYWORDS:
Preterm Birth, Preterm Labor, Vaginal Progesterone
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.4,
April
10,
2018
ABSTRACT: Objective: To evaluate whether prophylactic administration of 200 mg vaginal
progesterone can reduce the incidence of preterm birth in women with documented
history of preterm birth Setting: Obstetrics and Gynecology Department,
Zagazig University Hospital, Egypt. Methods: Ninety patients with previous history of preterm
birth prior to 37 week presenting with singleton pregnancy between 20 - 24
weeks were randomly allocated to receive either the progesterone 200 mg vaginal
suppository or no treatment. Results: The incidence of preterm labor before 37 weeks of gestation was
significantly lower in the study group than in the control group (22.2% vs. 53.3%)
especially in earlier gestational ages. While, the mean birth weight was
significantly higher in the study group than in control group (2872.67 ± 565.76
gm vs. 2487.78 ± 742.40 gm). The neonatal morbidities and mortality associated with preterm labor were
significantly lower in the study group than in the control group as shown by
lower incidence of neonatal RDS (13.3% vs. 31.1%; P = 0.043) and lower incidence of the
need for NICU admission (15.6% vs. 35.5%; P = 0.03). Conclusion: Administration of prophylactic vaginal progesterone
(200 mg, daily) can significantly reduce the rate of preterm birth before 37,
32 and 28 wks of gestation among women with previous spontaneous preterm birth.
In addition, the rates of RDS and admission to NICU were significantly
decreased among infants of women assigned to progesterone treatment. Also,
there was an additional benefit of vaginal progesterone for prevention of
preterm birth in women who had prior spontaneous preterm birth and cervical
length 25 mm.