EFFECT OF PROGESTERONE IN MANAGEMENT OF THREATENED PRETERM LABOUR

Abstract

Background: Threatened preterm labour is a common obstetric complication that substantially increases the risk of spontaneous preterm birth, neonatal morbidity, and neonatal mortality. Progesterone plays an essential role in maintaining pregnancy among women presenting with threatened preterm labour. Aim: To determine the effect of vaginal progesterone in the management of threatened preterm labour by evaluating pregnancy prolongation and delivery outcomes. Methods: This descriptive case series was conducted in the Department of Obstetrics and Gynecology, Gulab Devi Hospital, Lahore during the period 15th April 2026 and 15th July 2026. A total of 117 women with threatened preterm labour were enrolled using non-probability consecutive sampling. Eligible participants received vaginal micronized progesterone 400 mg once daily until 37 weeks of gestation or delivery. Maternal demographic characteristics, obstetric history, cervical length, latency period, gestational age at delivery, and pregnancy outcomes were recorded using a structured proforma. Data were analyzed using IBM SPSS Statistics version 26. Continuous variables were summarized as mean ± standard deviation, categorical variables as frequencies and percentages, and associations were assessed using the Chi-square test, Fisher's exact test, and independent t-test, with p < 0.05 considered statistically significant. Results: The mean maternal age was 28.3 ± 4.6 years, while the mean gestational age at presentation was 26.0 ± 3.4 weeks. The mean cervical length measured by transvaginal ultrasonography was 25.2 ± 5.8 mm, and the mean latency period following progesterone therapy was 84.1 ± 27.8 days. The mean gestational age at delivery was 38.0 ± 1.9 weeks, with 83.8% (98/117) of women achieving term delivery and 16.2% (19/117) delivering preterm. Women with term delivery had significantly greater gestational age at presentation (p = 0.002), longer cervical length (p < 0.001), and longer latency period (p < 0.001) than those with preterm delivery. Gravidity, previous miscarriage, and previous caesarean section were not significantly associated with pregnancy outcome, whereas mode of delivery demonstrated a significant association (p = 0.006). Conclusion: Vaginal progesterone was associated with prolonged pregnancy and a high rate of term delivery among women with threatened preterm labour. Earlier gestational age at presentation, shorter cervical length, and reduced latency period were significantly associated with preterm birth.