Oral dydrogesterone could not prevent miscarriages in women with threatened miscarriage: Study

Bangkok: A recent study in Thai pregnant women concluded that oral dydrogesterone 20 mg per day could not prevent miscarriages in women with threatened miscarriages.

This randomized, controlled study was carried out to determine the effectiveness of oral dydrogesterone in preventing miscarriage in threatened miscarriage. The study’s findings have been published in the Journal of Maternal-Fetal & Neonatal Medicine.

The study enrolled 100 pregnant Thai women at the gestational age of six to less than 20 weeks with threatened miscarriage from August 2021 to August 2022 from King Chulalongkorn Memorial Hospital, Bangkok, Thailand. These pregnant women were randomized to receive oral dydrogesterone 20 mg per day (n=50) or placebo (n=50) twice a day until one week after vaginal bleeding stopped or otherwise for a maximum of six weeks.

The result showed that the rate of continuing pregnancy beyond 20 weeks of gestational age was 90.0% (45 out of 50 women) in the dydrogesterone group and 86.0% (43 out of 50 women) in the placebo group (p = 0.538). The mean gestational age of delivery was 37 weeks for both groups (p = 0.302). Cesarean section was the most common delivery route in both groups (60.0% in dydrogesterone and 53.5% in placebo groups, respectively). The incidence of adverse events did not differ significantly between the groups.

Dydrogesterone is a synthetic progesterone with a high specificity to progesterone receptors in the human body. The drug is known to have a high bioavailability, which makes it effective in lower doses. The oral route is considedered better than the vaginal route in a higher blood concentration of the drug, especially when vaginal bleeding is faced. The study concluded that oral dydrogesterone 20 mg/day could not prevent miscarriages in women with threatened miscarriages.

Reference: Kuptarak, Arissara, and Vorapong Phupong. “Oral dydrogesterone for prevention of miscarriage in threatened miscarriage: a randomized, double-blind, placebo-controlled trial.” The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians vol. 37,1 (2024): 2333929. doi:10.1080/14767058.2024.2333929