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Assessment of sub‐endometrial blood flow parameters following dydrogesterone and micronized vaginal progesterone administration in women with idiopathic recurrent miscarriage: A pilot study
Author(s) -
Ghosh Sanghamitra,
Chattopadhyay Ratna,
Goswami Sourendrakanta,
Chaudhury Koel,
Chakravarty Baidyanath,
Ganesh Ashalatha
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12456
Subject(s) - medicine , dydrogesterone , miscarriage , mifepristone , pregnancy , luteal phase , blood flow , gynecology , group b , diastole , obstetrics , estrogen , blood pressure , hormone , genetics , biology
Aim To evaluate differences in uteroplacental blood flow and pregnancy outcome in women with idiopathic recurrent spontaneous miscarriage ( IRSM ) following administration of micronized vaginal progesterone and oral dydrogesterone. Methods One hundred and thirty‐three women (aged 23–40 years) who had had early miscarriages and spontaneous conception participated. Oral dydrogesterone (group A , n = 51) and micronized vaginal progesterone (group B , n = 50) were administrated for luteal support and compared. Pregnant women without history of recurrent miscarriage served as controls (group C , n = 32). The outcome measures consisted of endometrial blood flow parameters by Doppler indices and ongoing pregnancy rate. Results Before progesterone supplementation, resistivity index ( RI ) and pulsatility index ( PI ) were found to be significantly higher in groups A and B as compared to controls. Although statistically not significant, end diastolic velocity ( EDV ) and systolic/diastolic ( S / D ) ratio was found to be superior in controls than IRSM women. Peak systolic velocity ( PSV ) was comparable between IRSM and non‐ IRSM groups. Following progesterone supplementation, groups A and B showed a highly significant reduction in RI , PI and an increase in EDV . A relative increase in the value of PSV was observed in group A as compared to group B . There was remarkable difference in S / D in both groups. Although not statistically significant, group C showed reduction in RI , PI , PSV , EDV and S / D ratio. Pregnancy salvage rates were higher in group A (92.0%) as compared to group B (82.3%). Conclusion Progesterone supplementation appears to lower vascular resistance in women with IRSM . Oral dydrogesterone appears to be equally effective in improving endometrial blood flow as compared with micronized progesterone.