Comparison of efficacy of oral and vaginal progesterone to prevent preterm birth in pregnant women with short cervix: Randomized controlled trial

Abstract

Background: There is an evidence support that vaginal route of progesterone in pregnant woman with short cervix can prevent preterm delivery, but there are no data about preterm prevention for other route of progesterone

Objective: To study efficacy of oral route of progesterone in pregnant woman with cervical length 25 mm or less to prevent preterm birth, compare with vaginal route of progesterone

Materials and methods: A Randomized control trial, we measured the cervical length in the pregnant women at GA 20-25 weeks who visit the ANC clinic at Sunpasitthiprasong Hospital, then randomized 76 of them who cervical length 25 mm or less into 2 groups equally. The first group received progesterone 200 mg orally once daily and the second received progesterone 200 mg vaginal suppository once daily since they was included to the study until GA 34 weeks and measure cervical length again after 4 weeks of treatment. The primary outcome was preterm birth before 34 weeks of gestation

Results: The demographic data in the both groups were no different. The efficacy of oral and vaginal progesterone to prevent preterm birth before 34 weeks is not differ significantly. The women in the oral progesterone group (n = 38) has only 1 woman who was delivery before GA 34 weeks, and there are 3 women in the vaginal group (n = 36) that was delivery before GA 34 weeks (2.6% vs 10.5%, P-value 0.168).

Conclusion: There was no significantly different of efficacy of oral route of progesterone in pregnant woman with short cervical length to prevent preterm birth, compare with vaginal route of progesterone