Effect of Dydrogesterone on Treatment of Threatened Miscarriage: A Systematic Review and Meta-Analyses

Abstract

Objectives: We performed a systematic review and meta-analyses to assess the benefits and adverse effects of Dydrogesterone orally in treatment women with threatened miscarriage.

Methods: We searched four online databases including Pub Med and Scopus, Ovid and Science Direct. The key search terms were “threatened miscarriage” or "pregnancy loss” and "dydrogesterone" This study was a systematic review examining pregnant women with threatened miscarriage treated with dydrogesterone orally compared with no treatment without language restriction were included. Studies were evaluated for relevance and methodological quality. The primary outcome was continuing pregnancy beyond 20 weeks gestational age.

Results: Three randomized controlled trials (480 women) were included. For women with threatened miscarriage, dydrogesterone was associated with a significant reduction in miscarriage OR 0.41, 95% CI 0.25 to 0.68, P= 0.0005 I²=2%, it was more effective than no treatment in treating miscarriage and achieving term deliveries OR 2.07, 95% CI 1.24 to 3.48, P= 0.0006 I²=17%. No statistically significant benefit was found in preventing preterm labor OR 1.11, 95% CI 0.45 to 2.70, P= 0.82 I²=2% and incidence of obstetrical complications. However, our review suffered from a small sample- size and the included studies were relatively poor quality.

Conclusions: There is insufficient data on the effect of dydrogesterone on threatened miscarriage, as the result was obtained from pooling together three studies of poor methodological quality,Therefore one needs to be caution in interpreting the results. Large sample-size, double-blind, randomized controlled trials are needed.