Oral Versus Vaginal Progesterone In Preterm Labor

Abstract

Background: Preterm labor (PTL) remains a distressing issue in modern obstetrics, and still associated with poor impact on the perinatal outcomes world-wide. Progesterone plays a vital role in preventing the PTL.Objective: To compare different route of progesterone administration on the perinatal outcomes.Patients and Methods: It was a prospective comparative clinical trial, conducted at Suez Canal University Hospitals, Ismailia from December 2015 to January 2017. One hundred and thirty eight pregnant patients were randomly selected at 20–24 weeks gestation´ at risk of PTL and were classified into: 72 women received oral dydrogesterone 10 mg twice a day [Duphastone®] (Oral group) and 66 women received vaginal progesterone 200 mg vaginally twice a day [Prontogest®] (vaginal group). The primary outcome measures were gestational age at delivery in weeks, birth weight in grams, Apgar score at 1 and 5 minutes, the need for neonatal intensive care unit admission and neonatal mortality.Results: There was a significant difference between both group in favor to the vaginal group in all the studied outcome measures (p value < 0.05) with the exception of the Apgar score at 5 minutes post delivery (p value = 0.1). No cases of perinatal mortality in the vaginal group and only 3 cases in the oral group.Conclusion: The vaginal route is of better and significant results.