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Progesterone treatment reduces miscarriage risk in women with first-trimester bleeding and a history of recurrent pregnancy loss, with the greatest benefit seen in those with 3 or more previous miscarriages.
Danish medical authorities have introduced new guidelines advocating vaginal micronized progesterone (steroid hormone) for pregnant women experiencing first-trimester bleeding, particularly those with a history of recurrent pregnancy loss (also called spontaneous or involuntary abortion). The recommendations aim to minimize miscarriage risk by offering targeted hormonal support during early pregnancy.
Who Should Receive Progesterone?
The guidelines categorize women based on their history of pregnancy loss:
How Should Progesterone Be Used?
For eligible women, the guideline recommends:
Vaginal administration is preferred over oral or injectable progesterone because it delivers higher hormone levels directly to the uterus while minimizing systemic side effects.
Benefits and Risks
Clinical studies indicate that progesterone supplementation boosts pregnancy continuation rates in high-risk women. The treatment is generally well-tolerated, though few women may experience mild vaginal irritation, dizziness, or fatigue. Notably, research confirms that progesterone does not escalate the risk of birth defects or fetal abnormalities.
Why is This Important?
Threatened miscarriage—defined as vaginal bleeding in early pregnancy—is a common concern, often arousing substantial anxiety. While progesterone has been debated as a potential treatment, newer evidence supports its usage in women with a history of recurrent fetal loss.
Experts hope that these updated guidelines will help curtail miscarriage rates and offer a clear therapeutic strategy for high-risk pregnancies.
Danish Medical Journal
Treatment of threatened pregnancy loss
Anna Maria Kastner et al.
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