Progestogen for preventing miscarriage

Progestogen may not be more effective than placebo for preventing miscarriage in early to mid pregnancy in general, but women who have suffered three or more miscarriages may benefit from progestogen treatment.

A Cochrane review included 14 trials involving 2 158 women. There were no significant differences in the risk of miscarriage between progestogen and placebo or no treatment groups (Peto OR 0.99, 95% CI 0.78 to 1.24) and no statistically significant difference in the incidence of adverse effect in either mother or baby in the meta-analysis of all women, regardless of gravidity and number of previous miscarriages. In a subgroup analysis involving women with a history of three or more consecutive miscarriages, progestogen treatment showed a statistically significant decrease in miscarriage rate compared to placebo or no treatment (Peto OR 0.39, 95% CI 0.21 to 0.72; 4 studies, n=225). No statistically significant differences were found between the route of administration of progestogen (oral, intramuscular, vaginal) versus placebo or no treatment.

Comment: The quality of evidence is downgraded by limitations in study quality (e.g., inadequate or unclear allocation concealment and inadequate intention-to-treat adherence) and by inconsistency (heterogeneity in results in different populations).

Ədəbiyyat

1. Haas DM, Ramsey PS. Progestogen for preventing miscarriage. Cochrane Database Syst Rev 2008;(2):CD003511 [Review content assessed as up-to-date: 3 September 2013]. .