Objective: To evaluate whether prophylactic administration of 200 mg vaginal\nprogesterone can reduce the incidence of preterm birth in women with documented\nhistory of preterm birth <37 weeks of gestation or not. Setting: Obstetrics\nand Gynecology Department, Zagazig University Hospital, Egypt.\nMethods: Ninety patients with previous history of preterm birth prior to 37\nweek presenting with singleton pregnancy between 20 - 24 weeks were randomly\nallocated to receive either the progesterone 200 mg vaginal suppository\nor no treatment. Results: The incidence of preterm labor before 37 weeks of\ngestation was significantly lower in the study group than in the control group\n(22.2% vs. 53.3%) especially in earlier gestational ages. While, the mean birth\nweight was significantly higher in the study group than in control group\n(2872.67 �± 565.76 gm vs. 2487.78 �± 742.40 gm). The neonatal morbidities and\nmortality associated with preterm labor were significantly lower in the study\ngroup than in the control group as shown by lower incidence of neonatal RDS\n(13.3% vs. 31.1%; P = 0.043) and lower incidence of the need for NICU admission\n(15.6% vs. 35.5%; P = 0.03). Conclusion: Administration of prophylactic\nvaginal progesterone (200 mg, daily) can significantly reduce the rate of\npreterm birth before 37, 32 and 28 wks of gestation among women with previous\nspontaneous preterm birth. In addition, the rates of RDS and admission\nto NICU were significantly decreased among infants of women assigned to\nprogesterone treatment. Also, there was an additional benefit of vaginal\nprogesterone for prevention of preterm birth in women who had prior spontaneous\npreterm birth and cervical length < 25 mm.
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