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Progestogens for preventing miscarriage: a network meta-analysis.

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Summary
This summary is machine-generated.

Progestogen treatments generally show little effect on live birth rates for threatened or recurrent miscarriage. However, vaginal micronized progesterone may improve outcomes for women with a history of miscarriage and early pregnancy bleeding.

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Area of Science:

  • Reproductive Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Miscarriage is common, affecting 15-20% of pregnancies.
  • Progesterone plays a key role in maintaining pregnancy.
  • Progestogens are used to prevent miscarriage in threatened and recurrent cases.

Purpose of the Study:

  • To compare the effectiveness and safety of different progestogen treatments for threatened and recurrent miscarriage.
  • To rank progestogen treatments based on efficacy, safety, and side-effect profiles.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Searched multiple databases up to December 2020.
  • Assessed live birth rates, miscarriage, preterm birth, stillbirth, ectopic pregnancy, congenital abnormalities, and adverse drug events.

Main Results:

  • Vaginal micronized progesterone and dydrogesterone showed little to no difference in live birth rates for threatened miscarriage compared to placebo.
  • Vaginal micronized progesterone may increase live birth rates in women with recurrent miscarriage and early pregnancy bleeding.
  • Evidence for other progestogens and for certain outcomes remains limited or uncertain.

Conclusions:

  • Progestogens generally have minimal impact on live birth rates for threatened or recurrent miscarriage.
  • Vaginal micronized progesterone may benefit women with a history of miscarriage and early pregnancy bleeding.
  • Further research is needed to clarify the effectiveness and safety of alternative progestogen treatments.