Is there a role for progesterone in preterm labour

Abstract EN

Objective: To evaluate the role of progesterone in combination with half the usual dose of the ?-sympathomemetic (salbutamol) in treatment of actual preterm labour and to compare it with the full dose of ?-agonist used alone.

Methods: A randomized, controlled trial done at Baghdad teaching hospital and Al-Kadhimiyah teaching hospital, department of Obstetrics and Gynecology– Baghdad/Iraq, during the period from March 2006 to June 2007.

One hundred one pregnant women who presented with actual preterm labour were randomly divided into two groups.

Fifty-one patients received 17 hydroxyprogesterone hexanoate in oil (Primolut Depot) 250 mg with half the usual dose of salbutamol (1.25 mg/500 ml 5% dextrose) regarded as the study group and fifty patients received only salbutamol in the full dose (2.5 mg/500 ml 5% dextrose) regarded as the control group.

Both groups were compared for the time of delivery within 48 hours, 48 hours - one week, and after one week, for the maternal side effects of salbutamol and progesterone and for neonatal outcome for those delivered within 1 week.

Results: There was no significant difference between the control group and the study group regarding treatment-delivery interval within 1st 48 hours, 48 hours - one week, and after one week (p=0.6), nor regarding neonatal death or admission to neonatal care unit (p=0.078).

Maternal side effects of ?-agonist were reduced when half the dose of salbutamol in combination with a high dose of progesretone was used.

There was a highly significant reduction in tachycardia, hyperglycemia, nausea and vomiting (p=0.000), and a significant reduction in shortness of breath, restlessness, tremor and chest pain (p<0.05) in the study group compared to control group.

No significant difference existed between the two groups regarding headache (p=0.93).

No pulmonary edema developed in either group.

Conclusions: Progesterone could have a role in the treatment of actual preterm labour when used in combination with a ?-agonist to minimize the potentially life threatening side effects of ?-agonists.