To Determine the Frequency of Preterm Birth with Oral Progesterone in Female Presenting with Risk of Preterm Delivery
DOI:
https://doi.org/10.21649/akemu.v32i1.5979Keywords:
Preterm birth, prevention and control, oral progesteroneAbstract
Background: Preterm Birth (PTB) is the foremost reason of morbidity and mortality in newborns. Intramuscular 17-hydroxyprogesterone has been demonstrated to lower the risk of subsequent premature delivery. The potential of oral natural progesterone to prevent repeated preterm births has not been well investigated.
Objective: To determine the frequency of preterm birth (<37 weeks) among pregnant women at risk of preterm birth receiving oral progesterone from 28-34 weeks gestation over a period of 6 months.
Methodology: The Department of Obstetrics and Gynecology at Madina Teaching Hospital Faisalabad conducted this Descriptive case series. The study comprised 100 pregnant women presented in Gynae OPD & Emergency of Madina Teaching Hospital who satisfied the selection criteria. Patients were given oral progesterone twice daily till 36-37 weeks of gestation or delivery whichever occurs first. During follow-up, females were advised to present in situation of active labor and primary outcome measure is documented that is Frequency of preterm delivery <37 weeks of gestation.
Results: The patients average age was 28.61 + 3.72 years. Frequency of PTB with oral progesterone in female presenting with risk of PTB shows that 14% had preterm birth whereas 86% had Term birth. Distribution of cases by gestation age shows that 57% were between 28-30 weeks whereas 43% (n=43) were between 31-34 weeks of gestation, mean Gestational age was 30.46+2.11 weeks. Mean BMI of the patients was calculated as 30.49+2.01kg/m2.
Conclusion: Oral progesterone administration in females at risk of preterm delivery significantly reduces the frequency of preterm birth and may serve as an effective preventive strategy in high-risk pregnancies.
References
1. Daskalakis G, Goya M, Pergialiotis V, Cabero L, Kyvernitakis I, Antsaklis A, et al. Prevention of spontaneous preterm birth. Arch Gynecol Obstet [Internet]. 2019;299(5):1261–73. http://dx.doi.org/10.1007/s00404-019-05095-y
2. Jarde A, Lutsiv O, Beyene J, Mcdonald SD. Vaginal progesterone, oral progesterone, 17-OHPC, cerclage, and pessary forpreventing preterm birth in at-risk singleton pregnancies: an updated systematic review and network meta-analysis. BJOG. 2019;126:556–67 DOI: 10.1111/1471-0528.15566
3. Rahman RA, Atan IK, Ali A, Kalok AM, Ismail NAM, Mahdy ZA, et al. Use of the Arabin pessary in women at high risk for preterm birth: long-term experience at a single tertiary center in Malaysia. BMC Pregnancy Childbirth. 2021;21(1):368. http://dx.doi.org/10.1186/s12884-021-03838-x
4. Hyett J, Asadi N, Zare Khafri M, Vafaei H, Kasraeian M, Salehi A, et al. The use of vaginal progesterone as a maintenance therapy in women with arrested preterm labor: a double-blind placebo-randomized controlled trial. J Matern Fetal Neonatal Med. 2022;35(6):1134–40. :http://dx.doi.org/10.1080/14767058.2020
5. Mohamed M, Salama K, S Eldeen, A., Saafan, N. The Efficacy of Vaginal Progesterone in Reducing Preterm Birth in High-Risk Pregnancies. Benha J Appl Sci. 2020; 5(1): 317-22. doi: 10.21608/bjas.2020.135416
6. Hafeez S, Khan B, Khan M, Syed SZ, Waheed F, Mustafa R. Is Vaginal Progesterone More Effective to Treat Threatened Preterm Labour than Oral Nifedipine? Ann Pak Inst Med Sci. 2023; 19(4):441-5. DOI. 10.48036/apims.v19i4.977.
7. Rai P, Rajaram S, Goel N, Ayalur Gopalakrishnan R, Agarwal R, Mehta S. Oral micronized progesterone for prevention of preterm birth. Int J Gynaecol Obstet . 2009;104(1):40–3. http://dx.doi.org/10.1016/j.ijgo.2008.08.029
8. Rafiq T, Hayat N, Uzma S, Masher M, Fatima N, Rafi PMM. Progesterone: A hope to prevent preterm births & reduce perinatal mortality. PJMHS. 2023;17(3):304–6. http://dx.doi.org/10.53350/pjmhs2023173304
9. Di Renzo GC, Tosto V, Tsibizova V, Fonseca E. Prevention of preterm birth with progesterone. J Clin Med. 2021;10(19):4511. http://dx.doi.org/10.3390/jcm10194511.
10. Iqbal S, Hanif S, Nisa ZU, Shabbir A, Anwar K, Afridi N. Comparison of the effectiveness of oral progesterone and micronized progesterone pessary in reducing the spontaneous preterm birth incidences. PJMHS. 2023;17(2):395–8. http://dx.doi.org/10.53350/pjmhs2023172395
11. Luxenbourg D, Porat S, Romero R, Raif Nesher D, Haj Yahya R, Sompolinsky Y, et al. The effectiveness of vaginal progesterone in reducing preterm birth in high-risk patients diagnosed with short cervical length after 24 weeks: A retrospective cohort study. Front Med (Lausanne). 2023;10. 1130942. doi: 10.3389/fmed.2023.1130942.
12. Boelig RC, Della Corte L, Ashoush S, McKenna D, Saccone G, Rajaram S, et al. Oral progesterone for the prevention of recurrent preterm birth: systematic review and metaanalysis. Am J Obstet Gynecol MFM. 2019;1(1):50–62. http://dx.doi.org/10.1016/j.ajogmf.2019.03.001
13. Manuck TA, Stoddard GJ, Fry RC, Esplin MS, Varner MW. Nonresponse to 17-alpha hydroxyprogesterone caproate for recurrent spontaneous preterm birth prevention: clinical prediction and generation of a risk scoring system. Am J Obstet Gynecol. 2016;215(5):622-8. http://dx.doi.org/10.1016/j.ajog.2016.07.013
14. Das DA, Hemant D, Priya DS, Shinde DM, Madkar DCS. Comparative study of oral and vaginal natural micronized progesterone 300mg in preventing preterm labor in semi urban population. Int J Clin Obstet Gynaecol. 2022;6(4):01–4. http://dx.doi.org/10.33545/gynae.2022.v6.i4a.1185
15. Srisutham K, Wuttikonsammakit P, Chamnan P. Efficacy of Vaginal and Oral Progesterone After Tocolytic Therapy in Threatened Preterm Labor: A 3-Arm Parallel-Group Randomized Controlled Trial. J Med Assoc Thai. 2021;104:746–56. http://dx.doi.org/10.35755/jmedassocthai.2021.05.12018
16. Sun H, Sivasubramanian R, Vaidya S, Barve A, Jarugula V. Drug-drug interaction studies with oral contraceptives: Pharmacokinetic/pharmacodynamic and study design considerations. J Clin Pharmacol. 2020;60(2):49–62. DOI: http://dx.doi.org/10.1002/jcph.1765
17. Mazza GR, Komatsu E, Ponzio M, Bai C, Cortessis VK, Sasso EB. Progesterone therapy for prevention of recurrent spontaneous preterm birth in a minority patient population: a retrospective study. BMC Pregnancy Childbirth. 2024;24(1):252. https://doi.org/10.1186/s12884-024-06471-6
18. Bell EF, Hintz SR, Hansen NI, Bann CM, Wyckoff MH, DeMauro SB, et al. Mortality, in-hospital morbidity, care practices, and 2-year outcomes for extremely preterm infants in the US, 2013-2018. JAMA. 2022;327(3):248. http://dx.doi.org/10.1001/jama.2021.23580
19. Nelson DB, McIntire DD, Leveno KJ. A chronicle of the 17-alpha hydroxyprogesterone caproate story to prevent recurrent preterm birth. Am J Obstet Gynecol. 2021;224(2):175–86. http://dx.doi.org/10.1016/j.ajog.2020.09.045
20. Blackwell SC, Gyamfi-Bannerman C, Biggio JR Jr, Chauhan SP, Hughes BL, Louis JM, et al. 17-OHPC to prevent recurrent preterm birth in singleton gestations (PROLONG study): A multicenter, international, randomized double-blind trial. Am J Perinatol. 2020;37(2):127–36. http://dx.doi.org/10.1055/s-0039-3400227
21. Conde-Agudelo A, Romero R. Does vaginal progesterone prevent recurrent preterm birth in women with a singleton gestation and a history of spontaneous preterm birth? Evidence from a systematic review and meta-analysis. Am J Obstet Gynecol. 2022;227(3):440-61. http://dx.doi.org/10.1016/j.ajog.2022.04.02
22. Conde-Agudelo A, Romero R, Nicolaides KH. Cervical pessary to prevent preterm birth in asymptomatic high-risk women: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020;223(1):42-65. http://dx.doi.org/10.1016/j.ajog.2019.12.266
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