To compare the efficacy of progesterone between oral versus vaginal routes of administration in the treatment of first trimester threatened miscarriage

Abstract

Objective: To determine the efficacy of oral versus vaginal progesterone in the treatment of the first trimester threatened miscarriage.

Methodology: This randomized controlled trial study was conducted at Gynaecology and Obstetrics Department of Mardan Medical Complex, Mardan from September 2019 to March 2020. A total of 126 women between ages 18-45 years presenting in their first trimester with threatened miscarriage were included. All patients were randomly allocated in two equal groups A and B by lottery method (63 in each group). Patients in group A were given oral progesterone 10 mg bid for one week and group B patients were given vaginal progesterone 400 mg for one week under the supervision of obstetrician. All patients were followed up till 20th week of pregnancy. The efficacy of the drug was evaluated based on the absence of bleeding per vagina and pregnancy proceeding beyond 20 weeks of gestation.

Results: A total of 126 women were included. The majority of the patients 64 (50.79%) were between 18 to 30 years of age. The mean age of women in group A was 30.52 ± 4.52 years and in group, B was 30.73 ± 4.23 years. Efficacy of Oral progesterone (group A) was seen in 57 (90.48%) women and of vaginal progesterone (group B) was seen in 46 (73.02%) women. This showed a highly significant difference between the two routes of administration with p-value of 0.01.

Conclusion: Oral progesterone is more effective than vaginal progesterone in treating first trimester threatened miscarriage in terms of prevention of blood loss and continuing the pregnancy beyond 20 weeks.