Dydrogesterone vs. Progesterone: Which is More Effective in Threatened Miscarriage?
Öz
Background/Aims: Threatened miscarriage, marked by vaginal bleeding during the first 20 weeks of pregnancy, is a frequent complication with potential adverse outcomes. Dydrogesterone and micronized progesterone are commonly prescribed to manage this condition, yet their comparative efficacy remains under debate. This study aims to evaluate the effectiveness and safety of dydrogesterone versus micronized progesterone in treating threatened miscarriage.
Methods: A retrospective case-control study was conducted at Our Hospital, including 123 pregnant women aged 6 to 20 weeks presenting with uterine bleeding. Participants were divided into two groups based on receiving either dydrogesterone (n=56) or micronized progesterone (n=67). Pregnancy outcomes, including miscarriage rates, preterm labor, and mode of delivery, were recorded and analyzed using SPSS software.
Results: The miscarriage rate was slightly higher in the dydrogesterone group (9.6%) compared to the progesterone group (5.9%), though this difference was not statistically significant (p=0.729). Both groups exhibited high rates of successful delivery, with no significant difference between them (p>0.05). Additionally, no significant differences were observed in the incidence of pregnancy complications or mode of delivery between the two groups.
Conclusion: Both dydrogesterone and micronized progesterone are effective in managing threatened miscarriage, with no significant differences in pregnancy outcomes. The choice of treatment should be individualized based on patient tolerance and side effect profiles. Further large-scale, randomized trials are needed to confirm these findings and refine treatment guidelines.
Anahtar Kelimeler
Dydrogesterone, Miscarriage prevention, Progesterone, Progestin therapy, Threatened miscarriage
Destekleyen Kurum
This research received no specific grant from any funding agency in the public, commercial, or not-forprofit sectors
Etik Beyan
This study was approved by the Ethics Committee for Non-Drug and Non-Medical Device Research of KTO-Karatay University with the document date and number: 01.07.2024-87661 and the decision number 2024/64.
Kaynakça
- Bolger LA, O'Riordan N, Allen C. A rapid improvement event: progesterone prescribing in prevention of miscarriage. BMJ Open Qual. 2024;13(1).
- Duncan WC. Did the NICE guideline for progesterone treatment of threatened miscarriage get it right? Reprod Fertil. 2022;3(2):C4-c6.
- Devall AJ, Papadopoulou A, Podesek M, Haas DM, Price MJ, Coomarasamy A, et al. Progestogens for preventing miscarriage: a network meta-analysis. Cochrane Database Syst Rev. 2021;4(4):Cd013792.
- Mirza F, Patki A, Pexman-Fieth C. Dydrogesterone use in early pregnancy. Gynecological Endocrinology. 2016;32:106-97.
- Tetruashvili N, Shih E. Efficacy of Dydrogesterone in Threatened Miscarriage: a Systematic Review and Meta-analysis. DoctorRu. 2022.
- Carp H. A systematic review of dydrogesterone for the treatment of threatened miscarriage. Gynecological Endocrinology. 2012;28:983-90.
- Lou C, Wang C, Zhao Q, Jin F. Effect of dydrogesterone and progesterone on threatened miscarriage due to corpus luteum insufficiency. Am J Transl Res. 2021;13(5):4544-52.
- Kuptarak A, Phupong V. Oral dydrogesterone for prevention of miscarriage in threatened miscarriage: a randomized, double-blind, placebo-controlled trial. J Matern Fetal Neonatal Med. 2024;37(1):2333929.
- Shayna S, Celene Yan Yan H, Tan T, Allen J, Malhotra R, Truls Ø. Micronized Progesterone Compared With Dydrogesterone for Threatened Miscarriage: A Randomized Controlled Trial [328]. Obstetrics & Gynecology. 2015;125:104.
- Jia Yun SS, Allen J, Hui CY, Ku CW, Malhotra R, Truls Ø, et al. The randomised controlled trial of micronised progesterone and dydrogesterone (TRoMaD) for threatened miscarriage. European journal of obstetrics, gynecology, and reproductive biology. 2018;228:319-24.