The Effectiveness of Progestogens in Reducing Preterm Birth Risk

Abstract

Objective: The study aims to evaluate the effectiveness of prophylactic vaginal progesterone in preventing preterm birth among women with a history of spontaneous preterm birth.

Methodology: The study was conducted at the department of gynae & Obs, Ayub teaching hospital Abbottabad, from February 2022 to August 2022. IRB approved the study. This study investigated 125 women who had previously given birth prematurely. Demographic, medical, and obstetric data were collected before treatment initiation. Participants self-administered the study drug daily and returned to the study center every 2 weeks for monitoring. The study drug was continued until 36 weeks of delivery. Standard preterm labor treatment was provided as needed. All information was recorded on a standardized form.

Results: The mean age of participants was 29 years (SD±8.631), 38% were first-time mothers, and 62% had prior births. The study of 125 women with a history of spontaneous preterm birth found that prophylactic vaginal progesterone was associated with a successful pregnancy outcome in 88% of participants. The average gestational period at delivery in the study was 34 weeks (SD±3.455). While the study demonstrates a positive trend, it's important to note that without a comparison group (e.g., a placebo or no treatment group), it's impossible to calculate a precise p-value demonstrating the statistical significance of the progesterone's effect. The 88% success rate suggests a potential benefit, but further research with a control group is necessary to confirm efficacy and determine statistical significance. These findings support the existing practice of using prophylactic vaginal progesterone in women with a history of spontaneous preterm birth. The high percentage of successful pregnancies (88%) reinforces its potential benefit.

Conclusion: Prophylactic vaginal progesterone significantly reduced the risk of preterm birth by 88% in women with a prior history, demonstrating its potential to improve pregnancy outcomes for this high-risk population. However, the specific efficacy of vaginal progesterone can vary, and it is important to discuss individual risk factors and treatment options with a healthcare provider.

Keywords:  Cervical Length, Drug Therapy, Progesterone, Preterm Birth, Pregnancy Complications,