Progestogen for treating threatened miscarriage

Wahabi, Hayfaa; Althagafi, Nuha F Abed; Elawad, Mamoun; Zeidan, Rasmieh A Al

doi:10.1002/14651858.cd005943.pub3

Cited by 57 publications

(48 citation statements)

References 45 publications

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“…As well as inducing secretory changes in the endometrium during the luteal phase that promote implantation and support early pregnancy [5,6], it modulates the maternal immune response to prevent foetal rejection [7] and relaxes the uterine smooth musculature [8]. Despite this physiological evidence, which has led to progestogens being used in the management of threatened miscarriage for many years, there is little data available from well designed and well controlled clinical trials to support their routine use in this indication [9].…”

Section: Introductionmentioning

confidence: 99%

Dydrogesterone in threatened miscarriage: A Malaysian experience

Pandian

2009

Maturitas

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Section: Introductionmentioning

confidence: 99%

Dydrogesterone in threatened miscarriage: A Malaysian experience

Pandian

2009

Maturitas

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“…Sekitar 50-60% abortus dapat disebabkan oleh karena adanya kelainan kromosom janin, infeksi, kelainan endokrin, dan kelainan anatomi uterus, dan sekitar 40-50% belum bisa dijelaskan. 2 Abortus iminens ditandai oleh perdarahan vaginal pada kehamilan trimester pertama, dengan atau tanpa nyeri perut dan serviks masih tertutup serta janin masih viabel dan berada di dalam uterus. Ketika serviks mulai berdilatasi, abortus atau kegagalan kehamilan tidak akan terelakkan.…”

Section: Pendahuluanunclassified

Perbandingan Antara Pemberian Progesteron Vaginal Dan Allylestrenol Oral Pada Penanganan Abortus Iminens

Dhani

Emilia

Siswosudarmo

2015

JKR

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Background: Abortion is still the most common complication of pregnancy. Inadequate secretion of progesterone in early pregnancy has been associated with one of the cause of miscarriage. Progesterone supplementation has been used to prevent abortion but it is still debatable. Objective: To compare the success rate of vaginal progesterone vs oral allylestrenol in the treatment of threatened abortion and duration of maintaining pregnancy. Method: Randomized Clinical Trial. The study was conducted at four affiliated hospitals of Sardjito hospital Yogyakarta from November 2013 to May 2014. Subjects with the diagnosis threatened abortion meeting the following criteria were included: 8-16 weeks gestational age, hemoglobin content eH 10 g/dL, and live fetus. The following patients were excluded: there was a history of induced abortion, hormonal treatment, associated with IUD use, uterine anomaly and gynecology tumor. A total of 60 patients were recruited to obtain 0.6 times proportion difference and 80% power of study. Eligible subjects consisting of 30 and 29 were randomly allocated into vaginal progesterone and oral allylestrenol groups. Ability to maintain, duration of pregnancy and side effects were outcomes of interest. Chi-square, t-test, Fisher exact test and survival analysis were used for statistical analysis. Result & Discussion: Abortion rate in vaginal progesterone was 23.3% compared 37.9% with oral allylestrenol group (RR=0.61; 95% CI 0.27-1.36). Duration of maintaining pregnancy was 16.57 days vs 9.82 days in vaginal progesterone and oral allylestrenol respectively (mean difference 6.75 days; 95% CI 2.30-11.20). There was no difference in term of gestational age on the abortion rate (p>0.05). One case undergoing nausea was found in oral allylestrenol group. Conclusion: There was no difference between vaginal progesterone and oral allylestrenol in term of abortion rate. Vaginal progesterone could maintain pregnancy longer than oral allylestrenol.

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“…A recent Cochrane meta-analysis including 4 studies and 421 participants found a reduction in the rate of threatened abortion by the use of progesterone compared with placebo or no treatment (risk rate: 0.53; 95% CI: 0.35-0.79) [114].…”

Section: Progesterone To Prevent Miscarriagementioning

confidence: 99%

The role of progesterone and the progesterone receptor in human reproduction and cancer

Check

Cohen

2013

Expert Review of Endocrinology & Metabolism

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Insufficient progesterone, effect possibly more on immune factors rather than adequate endometrial development, can be an easy remedial cause of infertility by simply supplementing the luteal phase with either vaginal or intramuscular or oral (dydrogesterone) progesterone. Progesterone will also help to reduce miscarriage rates when follicle maturing drugs are used for those with regular menses but follicular maturation defects, or women with recurrent miscarriages. One mechanism of action seems to be related to production of an immunomodulatory protein, the progesterone-induced blocking factor either in the cytoplasm or in the circulation. PIBF inhibits cytotoxicity of natural killer cells. Cancer cells may 'borrow' the same mechanism to escape NK cell immunosurveillance. KEYWORDS: cancer • growth factors • immunosuppression • infertility • miscarriage • preterm delivery • progesterone• progesterone receptor • progesterone receptor antagonist • progesterone-induced blocking factor

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Progestogen for treating threatened miscarriage

Abstract: Analysis 1.3. Comparison 1 Progestogens versus placebo or no treatment, Outcome 3 Pregnancy-induced hypertension. Analysis 1.4. Comparison 1 Progestogens versus placebo or no treatment, Outcome 4 Antepartum haemorrhage.. .

Cited by 57 publications

References 45 publications

Dydrogesterone in threatened miscarriage: A Malaysian experience

Dydrogesterone in threatened miscarriage: A Malaysian experience

Perbandingan Antara Pemberian Progesteron Vaginal Dan Allylestrenol Oral Pada Penanganan Abortus Iminens

The role of progesterone and the progesterone receptor in human reproduction and cancer

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