Dados do Trabalho

Title

Use of progesterone for recurrent abortion

Objective

Analyze the effectiveness of using progesterone in the treatment of
recurrent abortion.

Methods

This is an integrative review of articles published in PubMed, Cochrane
and SciELO databases in the last ten years, using the following descriptors:
“Abortion, habitual”, “Progesterone” and “Recurrent abortion”. Paid studies,
performed on animals, reviews and duplicates were excluded.

Results

Three studies filled out the inclusion criteria. The first one was
multicentric, double-blind, placebo-controlled, randomized trial was conducted
with 836 women divided into two groups, one designated to receive vaginal
suppositories containing 400 mg of micronized progesterone and the other
placebo. A live birth rate after 24 weeks of gestation of 65.8% x 63.3% was
observed, with no significant increase in the pregnancy rate. The second
randomized and comparative study evaluated the effectiveness of oral
dydrogesterone 30 mg/day and vaginal progesterone 600 mg/day in 200 women.
The successful continuation of a viable pregnancy at 24 weeks, as well as the
term, was higher in patients receiving oral dydrogesterone compared to
intravaginal progesterone (75 vs 70). However, despite the study demonstrating
benefit in the use of progesterone, the difference between the two groups was
not statistically significant (p=0.5267), not indicating a clear advantage of one
treatment over the other. The third study, cohort, observational and prospective,
was carried out with 116 women with a history of recurrent pregnancy loss,
evaluating the use of vaginal micronized progesterone, prescribed at a dose of
100-200 mg every 12 hours, starting 3 days after the peak of LH (luteal onset).
Therefore, it was observed that, in women with high expression of glandular
epithelial nuclear cyclin E (nCyclinE) (> 20%) in the endometrial glands, the use
of luteal-onset vaginal micronized progesterone was associated with a higher
pregnancy success rate, with rates of 6% before its use and 69% in subsequent
pregnancies.

Conclusion

There is still no consensus in the literature regarding the
effectiveness of progesterone use among women with recurrent miscarriages.
More comparative studies assessing dosage and route of administration are
needed.

Keywords

Abortion, habitual; Progesterone; Recurrent abortion.