Progestogen for Preventing and Treating Threatened Miscarriage
|School||Xinjiang Medical University|
|Course||Obstetrics and Gynaecology|
|Keywords||progestogen preventing treating threatened miscarriage systematic review|
Objectives: To determine the efficacy and the safety of progestogens in the preventing and treatment of threatened miscarriage. Methods: We searched the relation article by computer and hand. We selection randomised or quasi-randomized controlled trials comparing progestogens with placebo or no treatment given in an effort to prevent miscarriage. At least two authors assessed the trials for inclusion in the review and extracted the data. We made meta analysis with RevMan software 5.0. Main results: Fourteen trials (1558 women) are included. The meta analysis of the women who had recurrent miscarriages (two or more consecutive miscarriages), progestogen treatment showed a statistically significant decrease in miscarriage rate compared to placebo or no treatment (OR 0.58; 95%CI 0.35 to 0.95).When regardless of gravidity and number of previous miscarriages, it is showed no statistically significant difference in the risk of miscarriage between progestogens and placebo or no treatment groups (OR 0.84; 95%CI 0.65 to 1.08). In a subgroup analysis, the oral progestogens (Dydrogesterone) maybe reduce the rate of miscarriage compared to placebo or no treatment (OR 0.42; 95%CI 0.25 to 0.76). But no statistically significant differences were found the intramuscular progestogens (Hydroxyprogesterone caproate) and vaginal progestogens versus placebo or no treatment. No statistically significant difference in the incidence of adverse effect in either mother or baby. Conclusions: It is benefit for the women who with a history of recurrent miscarriage to give progestogens to preventing and treatment of threatened abortion. In a subgroup analysis of different progestogens, the oral progestogens (Dydrogesterone) can be reduce the rates of miscarriage, but the intramuscular progestogens (Hydroxyprogesterone caproate) and vaginal progestogens maybe need to continue to assessment. There is no statistically significant difference between treatment and control groups in rates of adverse effects suffered by either mother or baby in the available evidence. Larger trials are currently underway to inform treatment for this group of women.