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Progestogens in the prevention of miscarriage.
Horm Mol Biol Clin Investig. 2016 Aug 01; 27(2):55-62.HM

Abstract

Progestational agents are often prescribed to prevent threatened miscarriage progressing to miscarriage, and subsequent miscarriages in recurrent pregnancy loss. Progestogens affect implantation, cytokine balance, natural killer cell activity, arachidonic acid release and myometrial contractility. A recent Cochrane review reported that progestogens were effective for treating threatened miscarriage with no harmful effects on mother or fetus. The results were not statistically different when vaginal progesterone was compared to placebo, (RR=0.47, 95% CI 0.17-1.30), whereas oral progestogen (dydrogesterone) was effective (RR=0.54, CI 0.35-0.84). The review concluded, that the small number of eligible studies, and the small number of the participants, limited the power of the metaanalysis. A later metaanalysis of five randomised controlled trials of threatened miscarriage comprised 660 patients. The results of 335 women who received dydrogesterone were compared to 325 women receiveing either placebo or bed rest. There was a 47% reduction in the odds ratio for miscarriage, (OR=0.47, CI 0.31-0.7). There was a 13% (44/335) miscarriage rate after dydrogesterone administration compared to 24% in control women. Recurrent miscarriage affects approximately 1% of women of child bearing age. A metaanalysis of progestational agents shows a 26% increase in the live birth rate. Again, dydrogesterone was associated with a more significant increase in the live birth rate than the other progestogens included in the metaanalysis.

Authors

No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26677905

Citation

Carp, Howard J A.. "Progestogens in the Prevention of Miscarriage." Hormone Molecular Biology and Clinical Investigation, vol. 27, no. 2, 2016, pp. 55-62.
Carp HJ. Progestogens in the prevention of miscarriage. Horm Mol Biol Clin Investig. 2016;27(2):55-62.
Carp, H. J. (2016). Progestogens in the prevention of miscarriage. Hormone Molecular Biology and Clinical Investigation, 27(2), 55-62. https://doi.org/10.1515/hmbci-2015-0058
Carp HJ. Progestogens in the Prevention of Miscarriage. Horm Mol Biol Clin Investig. 2016 Aug 1;27(2):55-62. PubMed PMID: 26677905.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Progestogens in the prevention of miscarriage. A1 - Carp,Howard J A, PY - 2015/10/26/received PY - 2015/11/09/accepted PY - 2015/12/19/entrez PY - 2015/12/19/pubmed PY - 2017/3/10/medline SP - 55 EP - 62 JF - Hormone molecular biology and clinical investigation JO - Horm Mol Biol Clin Investig VL - 27 IS - 2 N2 - Progestational agents are often prescribed to prevent threatened miscarriage progressing to miscarriage, and subsequent miscarriages in recurrent pregnancy loss. Progestogens affect implantation, cytokine balance, natural killer cell activity, arachidonic acid release and myometrial contractility. A recent Cochrane review reported that progestogens were effective for treating threatened miscarriage with no harmful effects on mother or fetus. The results were not statistically different when vaginal progesterone was compared to placebo, (RR=0.47, 95% CI 0.17-1.30), whereas oral progestogen (dydrogesterone) was effective (RR=0.54, CI 0.35-0.84). The review concluded, that the small number of eligible studies, and the small number of the participants, limited the power of the metaanalysis. A later metaanalysis of five randomised controlled trials of threatened miscarriage comprised 660 patients. The results of 335 women who received dydrogesterone were compared to 325 women receiveing either placebo or bed rest. There was a 47% reduction in the odds ratio for miscarriage, (OR=0.47, CI 0.31-0.7). There was a 13% (44/335) miscarriage rate after dydrogesterone administration compared to 24% in control women. Recurrent miscarriage affects approximately 1% of women of child bearing age. A metaanalysis of progestational agents shows a 26% increase in the live birth rate. Again, dydrogesterone was associated with a more significant increase in the live birth rate than the other progestogens included in the metaanalysis. SN - 1868-1891 UR - https://www.unboundmedicine.com/medline/citation/26677905/Progestogens_in_the_prevention_of_miscarriage_ L2 - https://www.degruyter.com/doi/10.1515/hmbci-2015-0058 DB - PRIME DP - Unbound Medicine ER -
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