Comparison of vaginal progesterone plus cervical cerclage versus vaginal progesterone alone in reducing preterm birth in high risk women.

Abstract

Objective: To compare the outcome of vaginal progesterone plus cervical cerclage versus vaginal progesterone alone in reducing preterm birth in high risk women. Study Design: Randomized Controlled Trial. Setting: Department of Obstetrics and Gynaecology, Bahawal Victoria Hospital, Bahawalpur. Period: April 2022 to October 2022. Material & Methods: A total of 330 high risk women aged between 18-40 with sonographically short cervix (<25 mm) were included. After randomization, in Group-A (n=165), cervical cerclage was done at 12 weeks and then 200 mg vaginal progesterone was given once daily at night till delivery while in Group-B (n=165) women, 200 mg vaginal progesterone was given once daily at night till delivery. All women were followed up till delivery and outcome (satisfactory/unsatisfactory) was noted. Results: In a total of 330 women, the mean age was 29.17±5.29 years while 194 (58.8%) women were aged between 18 to 30 years of age. Satisfactory outcome (no preterm birth in <37 weeks) was seen in 151 (91.5%) women in Group-A (combination of vaginal progesterone plus cervical cerclage) and 102 (61.8%) in Group-B (vaginal progesterone alone, p=0.0001. Conclusion: This study concluded that outcome of combination of vaginal progesterone and cervical cerclage is better as compared to progesterone alone in reducing preterm birth among high risk women.