Comparison of oral Dydrogesterone and 17-α hydroxyprogesterone caprate in the prevention of preterm birth

Abstract

Background Preterm birth (PTB) remains a significant problem in obstetric care. Progesterone supplements are believed to reduce the rate of preterm labor, but formulation, type of administration, and dosage varies in different studies. This study was performed to compare oral Dydrogesterone with intramuscular 17α-hydroxyprogesterone caproate (17α-OHPC) administration in prevention of PTB. Methods In this randomized clinical trial, we studied 150 women with singleton pregnancy in 28Th-34Th Gestational week, who had received tocolytic treatment for preterm labor. Participants were divided to receive 30 mg oral Dydrogesterone daily, 250 mg intramuscular 17α-OHPC weekly, or no intervention (control group). All treatments were continued until 37Th Week or delivery, whichever occurred earlier. Obstetric outcomes, including latency period, gestational age at delivery, birth weight, neonatal intensive care unit (NICU) admission, and neonatal mortality were recorded. All patients were monitored biweekly until delivery. Results Baseline gestational age was not significantly different between groups. Latency period was significantly longer in the progesterone group compared with Dydrogesterone and control groups (41.06 ± 17.29 vs. 29.44 ± 15.6 and 22.20 ± 4.51 days, respectively; P < 0.001). The progesterone group showed significantly better results compared with the other two groups, in terms of gestational age at delivery, birth weight, and Apgar score (P < 0.001). None of the participants showed severe complications, stillbirth, or gestational diabetes. Conclusion Progesterone caproate can strongly prolong the latency period and improve neonatal outcomes and therefore, is superior to oral Dydrogesterone in the prevention of PTB.

Progestogen maintenance therapy for prolongation of pregnancy after an episode of preterm labour: A systematic review and meta‐analysis

“…In case of any uncertainty regarding data integrity, several attempts were undertaken to contact authors for clarification. In case of no contact despite several attempts, studies were excluded (see Table S2 for more details on excluded trials), [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] as data trustworthiness could not be assessed for these studies. A sensitivity analysis investigating the primary outcome when including studies that were excluded based on data integrity is presented in Figure S1.…”

Unraveling the Efficacy of Therapeutic Interventions for Short Cervix: Insights from a Retrospective Study for Improved Clinical Management

“…There are various formulations of progesterone that can be administered orally, intravaginally, or intramuscularly. A recent randomized clinical trial of 150 pregnant patients at risk of preterm birth, who had received oral Dydrogesterone (30 mg/day), 17α-hydroxyprogesterone caproate (17α-OHPC, 250 mg intramuscular, weekly), or nothing, showed that progesterone caproate obtained superior results in prolonging the latency period until birth and improving neonatal outcomes in comparison with oral progesterone and placebo [ 33 ].…”