ROLE OF PROGESTERONE FOR MAINTENANCE TOCOLYTIC THERAPY AFTER THREATENED PRETERM LABOR

Abstract

Background: The rate of preterm labor is higher in the developing countries and it is the main cause of
neonatal mortality and morbidity. The prevention of preterm labor has become one of the major
objectives of perinatal medicine. The causes of P.T.L in most cases remains unclear. Additionally,
despite the identification of P.T.L risk factors; to date, no intervention has been associated with
decrease in P.T.L rates ,thus early detection women at high risk of P.T.L , and prophylactic treatment
could be one of the best ways to prevent P.T.L.
AIM of the Study: The aim of this study was to verify if vagianl progesterone maintenance therapy
after a successfully treated episode of preterm labor could increase latency period.
Patients and Methods: This prospective randomized trial was conducted in the Department of
Obstetrics and Gynecology, Zagazig University Hospitals during the period from March 2021 to
October 2021. It included 72 pregnant women at high risk for preterm labor. All patients received a
single course of dexamethasone, consisting of two injections of 12mg dexamethasone during the first
24 hours after admission. After stoppage uterine contraction the women were divided into 2 groups:
The first group (study group) comprised 36 patients. Women were given natural progesterone
(prontogest) 200 mg vaginal suppository daily. The second group (control group) comprised 36
patients. Women were not given any drugs and follow up and instructed to limit their physical activity.
Results: We found that progestional agents, reduce the risk of delivery less than 37 weeks of gestation
for women at increased risk of spontaneous preterm labour, but their effect in spontaneous abortion or
perinatal mortality, or measures of neonatal morbidity is uncertain.
Conclusion: prophylactic administration of 200 mg vaginal progesterone suppositories is associated
with a longer latency to delivery and better fetal outcome.