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Progestogens in Threatened Miscarriage

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Progestogens in Obstetrics and Gynecology

Abstract

Threatened miscarriage (bleeding during the first 20 weeks of pregnancy) may progress to miscarriage or may resolve. Progestational agents have been prescribed since the nineteen fifties in order to prevent threatened miscarriage progressing to miscarriage. There is much theoretical data to support the use of progestogens. Progestogens affect implantation, cytokine balance, natural killer cell activity, arachidonic acid release and myometrial contractility. Therefore, the question arises whether progestogens should be used in threatened miscarriage.

Since 2011, there have been a number of trials of progestogens in threatened miscarriage, albeit with different results regarding efficacy. Two forms of progestogen have mainly been used, oral dydrogesterone and vaginal micronized progesterone. Presently, the trials of dydrogesterone have shown an effect, whereas vaginal progesterone has not so far shown a statistically significant benefit. The different results may reflect the different progestogens used, or different patients with confounding factors.

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Authors and Affiliations

  1. Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel

    Howard J. A. Carp

  2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Howard J. A. Carp

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Correspondence to Howard J. A. Carp .

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  1. Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Howard J.A. Carp

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Carp, H.J.A. (2021). Progestogens in Threatened Miscarriage. In: Carp, H.J. (eds) Progestogens in Obstetrics and Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-030-52508-8_4

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  • DOI: https://doi.org/10.1007/978-3-030-52508-8_4

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