Comparative Outcome of Threatened Abortion between Patients Receiving Progesterone through Oral and Intramuscular Route

Abstract

Background: Threatened abortion is a common condition presenting with varied clinical manifestations. Progestogens have been taken into consideration as a possible healing alternative for the remedy of miscarriage more than 50 years. Objectives: To compare the efficacy and side effects of oral Dydrogesterone and intramuscular progesterone in the management of threatened abortion. Methods: This randomized clinical trial was carried out in the outpatient department (OPD) of Obstetrics & Gynaecology, Dhaka Medical College, Dhaka, from March 2017 to February 2018. A total of 80 threatened abortion patients were enrolled purposively in this study and they were randomly allocated equally into two groups by using a sealed envelope technique. In group I (oral group) oral tablet Dydrogesterone (10mg) and group II (intramuscular group) injection Progesterone (250 mg) was given up to 20 weeks. Serum progesterone level was estimated before starting treatment and after treatment. Detailed information was obtained in a pre-structured data sheet and were analyzed by SPSS-22 for windows. Result: The mean level of progesterone before treatment was 51.08±7.3 ng/ml in group I and 55.16±43.9 ng/ml in group II (p>0.05). The mean level of progesterone after treatment was found 75.0±9.66 ng/ml and 73.81±9.44 ng/ml in group I and group II respectively(p>0.05). The mean gestational age at delivery was found 37.45±1.94 weeks in group I and 37.08±2.14weeks in group II. Live birth observed 38(95.0%) in group I and 37(92.5%) in group II. A half (50.0%) subjects had nausea in group I and 15(37.5%) in group II. The difference was pain at the site of injection and induration formation at the site of injection statistically significant (p>0.05) and others were not significant between two groups. Conclusion: Dydrogesterone and progesterone are safe and simple to use in the management of threatened abortion.