distress syndrome with progestational agents. Most of the patients had
some of one or more risk factors for preterm birth prior to pregnancy.
Our study had homogenous comparable population prior to onset of
preterm labor. A similar study was carried out by Sedigheh BORNA
and Noshin SAHABI [21] in Tehran in 2004, where progesterone was
given to women after threatened preterm labor in one arm where as
another arm of patients received no treatment. There was significant
increase in mean latency until delivery, decrease in respiratory
distress syndrome, and decrease in low birth weight in progesterone
arm group. No significant differences were found between recurrent
preterm labor, admission to intensive care unit and neonatal sepsis
for the progesterone and control groups, respectively. Our study had
significantly decreased in incidence of recurrent preterm labor in
progesterone arm group.
All the study discussed above except that one by Sedigheh
BORNA and Noshin SAHABI, the comparison was difficult because
in other study it was to prevent the preterm labor with progesterone
with patients already having risk of preterm labor. Our study had
progesterone started after the arrest of preterm labor. The risk present
in our patient was episode of preterm labor arrested by tocolysis. There
was difference in type of progesterone use and the gestational age at
which they were recruited. In our study it was bit late (32 weeks).
The limitation of our study was small sample size and was not
compared with placebo. There was no blinding. So selection bias could
not be reduced.
Conclusion
Progesterone are promising agent to reduce the incidence of
recurrent preterm birth after arrest of preterm labor. Studies with
larger sample size with double blinding as well as earlier recruitment of
patient (at 28-32 weeks) would probably give more convincing results.
Acknowledgement
We would extend my sincere thanks to National Health Research Council for
supporting this research. We would lik