EFFICACY OF ORAL VS. VAGINAL PROGESTERONE IN EARLY PREGNANCY

Abstract

Background: Threatened miscarriage is a common complication in early pregnancy, affecting approximately 20% of pregnant women. Progesterone supplementation, through either oral or vaginal administration, is often used to prevent pregnancy loss. However, the relative efficacy of these two methods remains unclear. This study aims to compare the effectiveness of oral progesterone (Group A) and vaginal progesterone (Group B) in managing threatened miscarriage in the first trimester of pregnancy. Methods: A prospective, observational, and comparative clinical trial was conducted from January 2024 to December 2024. A total of 40 patients, aged 18 to 40 years, with pregnancies of less than 12 weeks' gestation, were enrolled in the study. Participants were randomly assigned to receive either oral progesterone (Group A) or vaginal progesterone (Group B). Efficacy was assessed based on the continuation of pregnancy at 12 weeks. Secondary outcomes included side effects, pregnancy complications, and stratification by age, gestational period, and parity. Results: The mean age for Group A (oral progesterone) was 30 years (±8.71) and for Group B (vaginal progesterone), it was 32 years (±7.96), with no significant difference between groups (P = 0.2384). In terms of efficacy, Group A showed 90% effectiveness, while Group B showed 80% effectiveness. The difference in efficacy was not statistically significant (P = 0.3999). Stratification by age, gestational period, and parity revealed no significant differences between the two groups in any category. Conclusions: Both oral progesterone and vaginal progesterone demonstrated similar efficacy in preventing pregnancy loss in women with threatened miscarriage during the first trimester. Oral progesterone showed a slightly higher effectiveness rate, but the difference was not statistically significant. These findings suggest that both treatments can be considered effective options for managing threatened miscarriage, with patient preference and treatment convenience playing a key role in clinical decision-making. Further studies with larger sample sizes are recommended to confirm these findings and explore the long-term outcomes of progesterone supplementation in early pregnancy.