In a nutshell
This study investigated the use of progestogen (PTG) to prevent miscarriage in women with recurrent miscarriages (RM).
They found that PTG reduces the chance of miscarriage in following pregnancies.
Some background
Pregnancy loss or miscarriage affects many women. Some women may experience several miscarriages, or recurrent miscarriages (RM). In some cases, the reason for RM is unclear. Progesterone is a female hormone that is very important in pregnancy. Progesterone causes the release of nutrients from glands in the uterus (womb). When the embryo enters the uterus, the uterine lining is primed and ready. The embryo then implants in the uterus. A sac is formed around the embryo and progesterone continues to be produced.
Without enough progesterone, miscarriage can occur. It is thought that RM may be caused by low progesterone levels. Progestogen (PTG) is a synthetic form of progesterone. PTG treatment may be useful in women with a history of RM. There is some debate about the effectiveness and safety of PTG.
Methods & findings
This study reviewed 13 clinical trials that included 2556 women with RM. The authors analyzed the birth outcomes of women treated with PTG compared to placebo (inactive drug) or no treatment. They determined the rates and risks of miscarriage.
The rate of miscarriage was lower in women treated with PTG compared to placebo (26.3% vs 19.4%). The risk of miscarriage was 31% lower with PTG treatment. Women with a history of 3 or more miscarriages had a 42% reduced risk of miscarriage after PTG treatment. The live birth rate was 11% higher in patients taking PTG. Treatment with PTG did not affect the rates of neonatal (baby) death, birth defects or birth weight.
The bottom line
The authors concluded that PTG treatment reduces the risk of miscarriage in following pregnancies.
The fine print
The authors suggested that the quality of the studies was medium. More investigation is needed to determine the effectiveness of PTG.
What’s next?
If you have any concerns regarding RM and PTG, please consult with your physician.
Published By :
Cochrane database of systematic reviews
Date :
Oct 08, 2018
