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Progestogens and pregnancy loss.
Climacteric 2018; 21(4):380-384C

Abstract

Progestational agents are often prescribed to prevent pregnancy loss. Progestogens affect implantation, cytokine balance, natural killer cell activity, arachidonic acid release and myometrial contractility. Progestogens have therefore been used at all stages of pregnancy including luteal-phase support prior to pregnancy, threatened miscarriage, recurrent miscarriage, and to prevent preterm labor. In luteal support, a Cochrane review reported that progestogens were associated with a higher rate of live births or ongoing pregnancy in the progesterone group (odds ratio 1.77, 95% confidence interval (CI) 1.09-2.86). Evidence suggests that progestogens are also effective for treating threatened miscarriage. Again, in a Cochrane Database review, progestogens were associated with a reduced odds ratio of 0.53 (95% CI 0.35-0.79) when progestogens were used. In recurrent miscarriage, progestogens also seem to have a beneficial effect. A meta-analysis of progestational agents showed a 28% increase in the live birth rate (relative risk 0.72, 95% CI 0.53-0.97). For the last 30 years, progestogens have been used to prevent preterm labor. Recent meta-analyses also report beneficial effects. This review summarizes the literature and the author's experience using progestogens to prevent pregnancy loss.

Authors+Show Affiliations

a Department of Obstetrics & Gynecology , Sheba Medical Center , Tel Hashomer , Israel.

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

29565684

Citation

Carp, H J A.. "Progestogens and Pregnancy Loss." Climacteric : the Journal of the International Menopause Society, vol. 21, no. 4, 2018, pp. 380-384.
Carp HJA. Progestogens and pregnancy loss. Climacteric. 2018;21(4):380-384.
Carp, H. J. A. (2018). Progestogens and pregnancy loss. Climacteric : the Journal of the International Menopause Society, 21(4), pp. 380-384. doi:10.1080/13697137.2018.1436166.
Carp HJA. Progestogens and Pregnancy Loss. Climacteric. 2018;21(4):380-384. PubMed PMID: 29565684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Progestogens and pregnancy loss. A1 - Carp,H J A, Y1 - 2018/03/22/ PY - 2018/3/23/pubmed PY - 2019/8/2/medline PY - 2018/3/23/entrez KW - Luteal support KW - pregnancy loss KW - preterm labor KW - progesterone KW - progestogens KW - recurrent miscarriage KW - threatened abortion KW - threatened miscarriage SP - 380 EP - 384 JF - Climacteric : the journal of the International Menopause Society JO - Climacteric VL - 21 IS - 4 N2 - Progestational agents are often prescribed to prevent pregnancy loss. Progestogens affect implantation, cytokine balance, natural killer cell activity, arachidonic acid release and myometrial contractility. Progestogens have therefore been used at all stages of pregnancy including luteal-phase support prior to pregnancy, threatened miscarriage, recurrent miscarriage, and to prevent preterm labor. In luteal support, a Cochrane review reported that progestogens were associated with a higher rate of live births or ongoing pregnancy in the progesterone group (odds ratio 1.77, 95% confidence interval (CI) 1.09-2.86). Evidence suggests that progestogens are also effective for treating threatened miscarriage. Again, in a Cochrane Database review, progestogens were associated with a reduced odds ratio of 0.53 (95% CI 0.35-0.79) when progestogens were used. In recurrent miscarriage, progestogens also seem to have a beneficial effect. A meta-analysis of progestational agents showed a 28% increase in the live birth rate (relative risk 0.72, 95% CI 0.53-0.97). For the last 30 years, progestogens have been used to prevent preterm labor. Recent meta-analyses also report beneficial effects. This review summarizes the literature and the author's experience using progestogens to prevent pregnancy loss. SN - 1473-0804 UR - https://www.unboundmedicine.com/medline/citation/29565684/Progestogens_and_pregnancy_loss L2 - http://www.tandfonline.com/doi/full/10.1080/13697137.2018.1436166 DB - PRIME DP - Unbound Medicine ER -