Micronized Progesterone Compared With Dydrogesterone for Threatened Miscarriage: A Randomized Controlled Trial [328]. (May 2015)

• Record Type: Journal Article
• Authors: Siew, Shayna; Yan Hui, Celene Yan; Tan, Thiam Chye; Allen, John Carson; Malhotra, Rahul; Ostbye, Truls
• Is Part Of: Obstetrics and gynecology. Volume 125(2015)Supplement 1
• Publication Date: 2015-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000463637.28791.c1
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Low serum progesterone and progesterone-induced blocking factor have been associated with miscarriage. In certain practices, women with threatened miscarriage are given progestogen, either as micronized progesterone or dydrogesterone. The aim of this study is to compare change in serum progesterone and progesterone-induced blocking factor pretreatment and posttreatment in women with threatened miscarriage, who were randomized to receive micronized progesterone or dydrogesterone. This study will also compare the extent of bleeding posttreatment and miscarriage rate. METHODS: Eighty-three women with a single intrauterine pregnancy presenting with threatened miscarriage between 6 and 10 weeks of gestation were recruited. Serum samples were collected at presentation, and progesterone and progesterone-induced blocking factor levels were quantified. Participants were randomized to micronized progesterone or dydrogesterone. They returned between day 4 and 6 for another serum measurement. The extent of bleeding during this visit was recorded. Occurrence of spontaneous miscarriage was ascertained at 16 weeks of gestation. RESULTS: Pretreatment progesterone levels were similar between both groups. However, posttreatment progesterone was significantly higher in women treated with micronized progesterone ( P <.001). Progesterone-induced blocking factor displayed a similar trend with no difference at baseline and significantly higher posttreatment levels for micronized progesterone ( P <.001). However, the extent of bleeding and miscarriage rates was not significantly different. The odds for miscarriage was lower in those who showed a positive percent change in progesterone-induced blocking factor posttreatment (odds ratio 0.074, P <.001). CONCLUSION: Micronized progesterone treatment led to a greater increase in serum progesterone and progesterone-induced blocking factor levels posttreatment. However, there was no significant difference in their clinical efficacy. Biochemical profile change can potentially be used to prognosticate outcome of treatment.