Efficacy of intramuscular progesterone in prevention of preterm birth in patients with history of preterm birth

Abstract

Background: Preterm birth is associated with many adverse outcomes and is defined as birth of a baby before 37 weeks of gestation. Around 15 million babies born preterm around the world with survival rates at different gestational like less 23 week, 23 weeks, 24 weeks and 25 weeks are 0%, 15%, 55% and 80% respectively. Progesterone has shown to reduce the incidence of preterm birth. Objective of the study was to find out frequency of preterm birth in patients (with previous history of preterm birth) treated with intramuscular progesterone.Methods: It was randomized controlled trial conducted in the department of Obstetrics and Gynecology, Unit-I, Sir Ganga Ram Hospital Lahore, Pakistan conducted from October 2017 to April 2018. It included 530 pregnant women with history of at least 1 previous preterm delivery presenting in antenatal clinic between 16-20 weeks of gestation. The lottery method was employed to segregate patients in two groups. Patients received intramuscular progesterone injection proluton depot 250 mg intramuscular weekly from 16-20 weeks till 37 weeks and other group received placebo drug.Results: Mean age was 27.52±4.57 years while the mean gestational age was 17.39±1.38 weeks. The mean gestational age at delivery was significantly higher among intramuscular group (36.14±2.23 versus 35.07±2.97 weeks; p=0.000). The frequency of preterm delivery was significantly lower in intramuscular group (24.9% versus 39.6%; p=0.000) as compared to placebo group.Conclusions: Frequency of preterm delivery was significantly lower in patients treated with intramuscular progesterone (24.9% versus 39.6%; p=0.000) irrespective of patients age, parity, BMI and number of previous preterm deliveries.