Vaginal Progesterone
to Prevent
Preterm Birth
in High-Risk Women
Abstract Preterm birth is a signifi cant problem in the United States, contributing to neonatal morbidity and mortality.
Progesterone is a hormone naturally produced by the corpus luteum and the placenta in early pregnancy and is essential for
maintaining pregnancy. Clinicians and researchers have used this hormone in later gestation to try to prevent preterm birth.
However, mechanisms of action, indications for use, dosing and administration have varied and are not fully understood.
Th is article revisits two recent randomized controlled trials in which researchers investigated the eff ectiveness of vaginal
progesterone suppositories and gel in the prevention of preterm birth among women who were at high risk for delivering
prematurely.
In this column, we will take a second look
at two recent randomized controlled trials in
which researchers investigated the eff ectiveness
of vaginal progesterone in the prevention of
preterm birth among women who were at high
risk for delivering prematurely. In the fi rst study,
Hassan et al. (2011) identifi ed women who had
a sonographic diagnosis of short cervix and
randomized the women to receive either vaginal
progesterone gel or placebo. In the second
study, Cetingoz et al. (2011) identifi ed women
who were at high risk for preterm birth based
upon history of previous preterm birth, current
twin gestation or existing uterine malformation.
Th ese researchers randomized the women to receive
either vaginal progesterone suppositories
or placebo. Both of these studies provide Level I
evidence
Vaginal Progesteroneto PreventPreterm Birthin High-Risk WomenAbstract Preterm birth is a signifi cant problem in the United States, contributing to neonatal morbidity and mortality.Progesterone is a hormone naturally produced by the corpus luteum and the placenta in early pregnancy and is essential formaintaining pregnancy. Clinicians and researchers have used this hormone in later gestation to try to prevent preterm birth.However, mechanisms of action, indications for use, dosing and administration have varied and are not fully understood.Th is article revisits two recent randomized controlled trials in which researchers investigated the eff ectiveness of vaginalprogesterone suppositories and gel in the prevention of preterm birth among women who were at high risk for deliveringprematurely.In this column, we will take a second lookat two recent randomized controlled trials inwhich researchers investigated the eff ectivenessof vaginal progesterone in the prevention ofpreterm birth among women who were at highrisk for delivering prematurely. In the fi rst study,Hassan et al. (2011) identifi ed women who hada sonographic diagnosis of short cervix andrandomized the women to receive either vaginalprogesterone gel or placebo. In the secondstudy, Cetingoz et al. (2011) identifi ed womenwho were at high risk for preterm birth basedupon history of previous preterm birth, currenttwin gestation or existing uterine malformation.นักวิจัยความเร็ว Th randomized ผู้หญิงรับยาเหน็บช่องคลอดโปรเจสเตอโรอย่างใดอย่างหนึ่งหรือยาหลอก ทั้งนี้การศึกษามีระดับฉันหลักฐาน
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