Oral versus Vaginal Micronized Progesterone for the treatment of threatened miscarriage

Parveen, Rashida; Khakwani, Mehnaz; Tabassum, Sobia; Masood, Sajjad

doi:10.12669/pjms.37.3.3700

Cited by 9 publications

(10 citation statements)

References 17 publications

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“…This is consistent with the findings reported by Naqvi M et al 24 Strength of our study: The strength of our study is that to our knowledge there are limited studies from South Asia addressing this issue and only one study from Pakistan has evaluated association of SCH with adverse pregnancy outcomes. 18 Other local studies have addressed management 25 and outcomes of threatened miscarriage 6 without SCH or focused on the sonographic features of SCH.…”

Section: Discussionmentioning

confidence: 99%

Subchorionic hematoma and pregnancy outcomes in patients with threatened miscarriage

Naz

Irfan

Naru³

et al. 2022

Pak J Med Sci

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Objective: To compare maternal and perinatal outcomes in patients with threatened miscarriage with or without subchorionic hematoma (SCH) at a tertiary care hospital. Methods: This retrospective cohort study was conducted at Aga Khan University Hospital. The study included 200 patients of <20 weeks singleton pregnancy with threatened miscarriage from January 2016 till December 2018. These patients were divided into two groups based on the presence (study group) or absence of subchorionic hematoma (control) on ultrasound imaging. Baseline demographic data, and obstetric outcomes were compared for the two groups. Results: The incidence of subchorionic hematoma was observed to be 30.5% (61/200). Most of the patients of SCH and non SCH groups presented in first trimester. Age and BMI were similar for both groups however there were more multigravida patients in the SCH group (63% versus 46.7%, P=0.12). A higher number of patients in the SCH group ended up in spontaneous miscarriage in contrast to patients with no SCH (13% versus 6.1%, P=0.07) and also had a greater proportion of small for gestational age (SGA) babies (8.9% versus 3.9%) though no statistical significance was observed. There were more preeclamptic patients in SCH group as compared to non SCH group (4.8% versus 0.7%) and the trend was statistically significant (P=0.05). However, no significant correlation of hematoma size and adverse pregnancy outcomes was found in SCH group. Conclusion: Our study shows that women with threatened miscarriage having SCH are at a higher risk of having preeclampsia and SGA and hence these pregnancies warrant greater surveillance. doi: https://doi.org/10.12669/pjms.38.3.4283 How to cite this:Naz S, Irfan S, Naru T, Malik A. Subchorionic hematoma and pregnancy outcomes in patients with threatened miscarriage. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4283 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Subchorionic hematoma and pregnancy outcomes in patients with threatened miscarriage

Naz

Irfan

Naru³

et al. 2022

Pak J Med Sci

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“…20 Oral Dydrogesterone or oral micronized progesterone 400mg in two divided doses lowered the rate of miscarriage, improved fetal circulation and was found safe( non teratotenic). 21,22,23 To prevent hypertensive disorder of pregnancy and its squeal, women with threatened miscarriage need evaluation of risk factors for hypertension development and vigilant monitoring during pregnancy. History of chronic hypertension, chronic renal disease, auto-immune diseases in family, anti-phospholipid antibody syndrome, BMI 35kg/m 2 , previous history of pre-eclampia were the indicators for the start of aspirin for prophylaxis of pre-eclampsia and its sequlae.…”

Section: Discussionmentioning

confidence: 99%

Maternal complications in women presenting with first trimester threatened miscarriage.

Saba

Iftikhar

Noonari

et al. 2022

TPMJ

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Objective: To determine the frequency of miscarriage, hypertensive disorder of pregnancy, placental abruption and preterm birth in women with first trimester threatened miscarriage. Study Design: Cross-sectional study. Setting: Department of Obstetric & Gynaecology, Sir Syed Hospital and Pakistan Naval Ship Shifa Hospital (Karachi). Period: April, 2021 to March, 2022. Material & Methods: Ninety two women 18-40 year old, diagnosed as threatened miscarriage at ≤ 13 weeks based on history, examination and ultrasound were included in the study after informed consent and followed till delivery. Women with genital infection, other form of miscarriage and multiple pregnancy were excluded. Data recorded from hospital documents. Maternal age, parity and Gestational age assessed. Miscarriage, hypertensive disorder of pregnancy, placental abruption, preterm birth and PPROM expressed as frequency and percentages. Logistic regression analysis performed. Chi square test (x2) used and P-value ≤ 0.05 taken as significant. Results: Mean age of women was 29.21±3.49 years. Mean parity was 2.65±1.15. Mean Gestational age at presentation was 7.96±1.78 weeks. 11.11%. (10/90) cases had miscarriage. 88.88% (80/90) women continued their pregnancy. 42.5% (34/80) had hypertensive disorder of pregnancy. 20% had pregnancy induced hypertension and 22.5% had pre-eclampsia. Preterm birth was seen in 26.3% (21/80). Frequency of PPROM and placental abruption was 6.3% (5/80) each. Women of 21-25 yr age were more at risk of hypertensive disorder of pregnancy than other age groups. There was no significant affect of maternal age and parity on preterm birth and placental abruption. Frequency of Preterm birth was 38.4% in women with hypertensive disorder, more than 2 times higher than non-hypertensives (17.4%) and found significant (P-value=0.043). Conclusion: Hypertensive disorder of pregnancy was the most common maternal complication observed in women who had threatened miscarriage in first trimester. Preterm birth had significant association with hypertensive disorder of pregnancy.

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“…The mean gestational age of patients in OMP group and VMP group was 31.37 ± 1.94 weeks and 33.49 ± 2.49 weeks respectively. Parveen R et al [13] randomized controlled trial found mean gestational age was 9.3+2.7 weeks.…”

Section: Comparison Of Birth Weight Of Neonates Between Groupsmentioning

confidence: 98%

Comparative study of oral and vaginal natural micronized progesterone 300mg in preventing preterm labor in semi urban population

Das¹,

G²,

Priya³

et al. 2022

Int. J. Clin. Obstet. Gynaecol.

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Preterm deliveries is the major contributors of neonatal mortalities and under 5 age group morbidities. Excessive use of Progesterone and its supplements, antenatal steroidal cover and tocolysis prevents this. In this study, there has been made an attempt to study the perinatal outcome of both mother and neonate revolving around premature deliveries by using two different routes for progesterone administration. A prospective study was done on randomly selected 300 patients who complained of pain abdomen after 24 weeks of pregnancy, and were followed up till delivery after administration of progesterone, after dividing into 2 separate groups. This leads to collection of data for interpretation of association of variation in various parameters with relation to use of different routes for micronized progesterone. When compared, users of Oral micronized progesterone (OMP) presented at 31.37±1.94 weeks for delivery and that of Vaginal micronized progesterone (VMP) presented at 33.49±2.49 weeks of gestation. 78.7% neonates of Oral group were asymptomatic at birth than those 90.7% of vaginal neonates. Incidence of neonatal morbidity, like signs of birth asphyxia (16.7% vs 3.3%), mean APGAR Score of 1 min (7.77±2.11 vs. 8.07±1.63), mean birth weight (2.89±0.67 vs. 3.19±0.61), NICU admission (13.3% vs 3.3%) were found to be higher in Oral group than Vaginal group. Administration of Vaginal micronized progesterone helps in reduction of preterm labor and the rate of neonatal NICU admissions, neonatal mortality and morbidity as compared to oral micronized progesterone. Vaginal progesterone surpasses the first pass metabolism explaining the better outcome of the vaginal in preventing preterm labor.

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Oral versus Vaginal Micronized Progesterone for the treatment of threatened miscarriage

Cited by 9 publications

References 17 publications

Subchorionic hematoma and pregnancy outcomes in patients with threatened miscarriage

Subchorionic hematoma and pregnancy outcomes in patients with threatened miscarriage

Maternal complications in women presenting with first trimester threatened miscarriage.

Comparative study of oral and vaginal natural micronized progesterone 300mg in preventing preterm labor in semi urban population

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