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Caroline Madsen1, Andreas Overby Ørsted2, Maria Birkvad Rasmussen3

  • 1Gynækologisk og Obstetrisk Afdeling, Københavns Universitetshospital - Rigshospitalet.

Ugeskrift for Laeger
|June 7, 2024
PubMed
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Prophylactic vaginal progesterone can reduce early preterm birth in high-risk pregnancies. This treatment is recommended for women with a history of preterm birth or a short cervix.

Area of Science:

  • Obstetrics and Gynecology
  • Perinatology
  • Neonatal Health

Background:

  • Preterm birth (less than 37 weeks gestation) is a major global cause of infant mortality and morbidity.
  • While incidence varies, it is notably lower in Nordic countries (5-6%).
  • Predicting and preventing preterm birth is challenging due to its varied causes.

Purpose of the Study:

  • To review current knowledge on the use of prophylactic progesterone to prevent preterm birth.
  • To identify high-risk pregnancies that may benefit from progesterone therapy.
  • To provide guidance on the optimal timing and indications for progesterone administration.

Main Methods:

  • Review of existing scientific literature on prophylactic progesterone and preterm birth.
  • Analysis of factors influencing preterm birth prediction, including obstetric history and cervical length.

Related Experiment Videos

  • Evaluation of treatment recommendations based on gestational age and risk factors.
  • Main Results:

    • Obstetric history and cervical length measurements can improve the prediction of preterm birth.
    • Prophylactic vaginal progesterone, given between 12-24 weeks gestation, is recommended for singleton pregnancies with a history of preterm birth or a short cervix (less than 25 mm).
    • This intervention is associated with a reduction in preterm birth before 33-35 weeks gestation.

    Conclusions:

    • Vaginal progesterone is an effective prophylactic measure for specific high-risk singleton pregnancies.
    • Consideration should be given to using progesterone in twin pregnancies with similar risk factors.
    • Early intervention with progesterone can significantly reduce the incidence of early preterm birth and associated neonatal complications.