Comparing Vaginal Progesterone and Intramuscular Progesterone (17α –Hydroxyprogestrone Caproate) in the Prevention of Preterm Birth

Abstract

Abstract

 Background: Preterm birth is a worldwide health concern due to its various negative consequences. Therefore, the prevention of preterm birth is a top priority for healthcare systems in all countries

Objective: To compare the effectiveness of vaginal versus intramuscular progesterone in the prevention of preterm delivery.

Methods: This randomized clinical trial was conducted at Maternity Hospital-Damascus university and my special clinic,withen the period from 23/4/2011 to 22/4/2015. 96 pregnant women with singleton pregnancy and one risk factor of preterm delivery were included in the study. They were then randomly allocated into Vaginal progesterone group (n=48) and intramuscular progestron (17α-hydroxyprogestrone caproate) group (n=48)  . Subsequently, we analyzed drug complications during pregnancy, delivery time, neonatal outcomes, and patients' satisfaction among the two groups. The Pearson chi-square and Student’s t test were used to compare two groups and ANOVA for the analyses of primary and secondary outcomes. The data were analyzed by Stata software version 13. 

Results: Among the 48 births in group one, 33.3% occurred preterm, and, among the 48 births in group two, 31.3% occurred preterm (< 37 weeks). The mean gestational ages at delivery in groups 1 and 2 were 37.07 ± 2.23 and 36.81 ± 2.77 weeks, respectively (p = 0.765). Other variables were not significantly different between the two groups, including birth weight (p = 0.745), Apgar scores for the first and fifth minutes (p = 0.574, 0.630), length of stay in the hospital when the newborns needed hospitalization (p = 0.358), and the patients' satisfaction with the drugs that were used (p = 0.615).

Conclusions: In this study, vaginal progesterone and intramuscular progesterone had the same levels of effectiveness, safety and acceptance by patients in the prevention of preterm delivery. Therefore, both can be used for this purpose in clinical practices, but more studies are needed to confirm this result or modify it.