Department of Obstetrics & Gynaecology, Seberang Jaya Hospital, Seberang Jaya, Penang, Malaysia. pandian
Maturitas. 2009 Dec;65 Suppl 1:S47-50. doi: 10.1016/j.maturitas.2009.11.016. Epub 2009 Dec 14.
Threatened miscarriage is a common problem during pregnancy.
The aim of this prospective, open, randomised study was to determine whether dydrogesterone was more effective than conservative management alone in preventing miscarriage in women with vaginal bleeding up to week 16 of pregnancy. Women were excluded if they had a history of recurrent miscarriage. A total of 191 women were randomised to dydrogesterone (40 mg stat followed by 10mg twice daily) or conservative management (control group). The treatment was considered successful if the pregnancy continued beyond 20 weeks of gestation.
The success rate in the dydrogesterone group was statistically significantly higher than that in the control group (87.5% vs. 71.6%; p<0.05). Miscarriage occurred in 12.5% of women in the dydrogesterone group compared with 28.4% in the control group (p<0.05). There were no differences between the groups with regard to the incidence of Caesarean section, placenta praevia, antepartum haemorrhage, preterm labour (weeks 28-36), pregnancy-induced hypertension or low birth weight (<2500 g) babies. There were no intrauterine deaths or congenital abnormalities in either group.
Compared with conservative management, dydrogesterone had beneficial effects on maintaining pregnancy in women with threatened miscarriage.
先兆流产是妊娠期间常见的问题。
本前瞻性、开放、随机研究旨在确定地屈孕酮是否比单纯保守治疗更能有效预防妊娠 16 周内阴道出血的女性流产。如果患者有复发性流产史，则将其排除在外。共 191 名女性被随机分为地屈孕酮（40mg 即刻，随后每日 2 次 10mg）或保守治疗（对照组）。如果妊娠持续到 20 周以上，则认为治疗成功。
地屈孕酮组的成功率明显高于对照组（87.5% vs. 71.6%；p<0.05）。地屈孕酮组 12.5%的女性发生流产，而对照组为 28.4%（p<0.05）。两组间剖宫产、前置胎盘、产前出血、早产（28-36 周）、妊娠高血压或低出生体重（<2500g）婴儿的发生率无差异。两组均无宫内死亡或先天性异常。
与保守治疗相比，地屈孕酮对维持有先兆流产风险的女性妊娠有有益作用。
