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

Abstract

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.