پزشکی بالینی ابن سینا (Jun 2024)

Comparison of the Effect of Micronized Progesterone (Utrogestan) and Hydroxyprogesterone Caproate (Proloton) on Maternal and Fetal Blood Circulation in Women at Risk of Preterm Labor

  • Elaheh Mesdaghinia,
  • Masoumeh Abedzadeh-Kalahroudi,
  • Mojtaba Sehat,
  • Mansooreh Noormandipour

Journal volume & issue
Vol. 31, no. 1
pp. 5 – 11

Abstract

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Background and Objective: Preterm birth is one of the leading causes of death and disability in neonates. In recent years, progestins have been used to prevent preterm labor. This study aimed to compare the effects of micronized progesterone (Utrogestan) and hydroxyprogesterone caproate (Proloton) on maternal and fetal blood circulation in women at risk of premature delivery. Materials and Methods: This randomized, single-blind clinical trial study was conducted on 80 pregnant women at 20-34 weeks who were at risk of preterm labor. At first, Doppler ultrasound of the uterine, umbilical, and mid-cerebral arteries was performed. Subsequently, patients were randomly allocated in two groups receiving oral progesterone (200 mg of Utrogestan twice daily) for 48 hours and intramuscular progesterone (500 mg of Proluton). After one week, ultrasonography was repeated in both groups, and pulsatile index (PI), resistance index (RI), peak systolic velocity (PSV), and systolic to diastolic ratio (S/D) were measured. Results: The two groups were similar in terms of age, body mass index, gestational age, gravida, history of preterm labor, cervical length, and initial cervical dilatation. The decrease in uterine artery RI and S/D was greater after Proloton administration than Utrogestan (P<0.05). In the Proloton group, the S/D index of the umbilical artery decreased significantly (P=0.021); however, this difference was not significant in the Utrogestan group. The mean S/D and PSV indexes of the middle cerebral artery were significantly different between the two groups (P<0.05). Conclusion: The two medications had similar effects on uterine and umbilical circulation. Proluton had a better effect on fetal cerebral circulation. Therefore, any of the above medications can be used based on the patient's preferences and available facilities.

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