Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 8 , ISSUE 2 ( April-June, 2014 ) > List of Articles


Neonatal Outcomes after Preconceptional Vaginal Micronized Progesterone Administration in Recurrent Pregnancy Loss: Five Years Prospective Study

Manuela Russu, Ruxandra Stănculescu, Maria Păun, Jan Andi Marin

Keywords : Vaginal micronized progesterone,Preconception,Miscarriage,Prematurity

Citation Information : Russu M, Stănculescu R, Păun M, Marin JA. Neonatal Outcomes after Preconceptional Vaginal Micronized Progesterone Administration in Recurrent Pregnancy Loss: Five Years Prospective Study. Donald School J Ultrasound Obstet Gynecol 2014; 8 (2):128-133.

DOI: 10.5005/jp-journals-10009-1347

License: CC BY-NC 4.0

Published Online: 01-12-2014

Copyright Statement:  Copyright © 2014; The Author(s).



The objective of this prospective study was to analyze the effect of vaginal micronized progesterone (VMP) daily administrated in women with recurrent pregnancy loss, recurrent miscarriage, and/or preterm birth on neonatal outcomes.


In the treat group patients received 200 mg/day VMP (14 days/month, during the luteal phase) from preconception until completed 36 weeks of gestation. Women from the control group did not receive VPM treatment. Ultrasonographic examination was performed for gestational age confirmation, assessment of cervical length and congenital malformation screening in fetus.


Compared with the control group, the women from the VMP group had a decreased time to conception, lower frequency of miscarriages and higher gestational age at delivery. Newborns from mothers treated with VPM had significantly higher birth weight than newborns from the control group of mothers (p = 0.022). The frequency of stillbirths and the need for oxygen supplementation and mechanical ventilation was lower in the newborns from treated group of mother compared with control group.


Vaginal micronized progesterone 200 mg/day from preconception to 36 weeks of gestation in women with recurrent pregnancy loss reduced the frequency of miscarriages, stillbirths, preterm births and neonatal morbidity.

How to cite this article

Russu M, Stănculescu R, Păun M, Marin JA. Neonatal Outcomes after Preconceptional Vaginal Micronized Progesterone Administration in Recurrent Pregnancy Loss: Five Years Prospective Study. Donald School J Ultrasound Obstet Gynecol 2014;8(2):128-133.

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  1. DNA variants of maternal and fetal genes may be linked to preterm birth. Abstract 14. The 30th Annual Meeting of the American Society for Maternal-Fetal Medicine: The Pregnancy Meeting 2010.
  2. Hormones, cytokines and fetal anomalies in habitual abortion. Gynecol Endocrinol 2001;15:472-483.
  3. Progesterone in pregnancy; receptor-ligand interaction and signaling pathways. J Reprod Immunol 2009;83:60-64.
  4. Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev 2004;3:CD004830.
  5. Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev 2011;10:CD009154.
  6. Progestogen for treating threatened miscarriage. Cochrane Database Syst Rev 2007;3:CD005943.
  7. Prenatal administration of progesterone for preventing preterm birth. Cochrane Database Syst Rev 2006;1:CD004947.
  8. Neonatal Outcomes after preconceptional vaginal micronized progesterone administration in recurrent pregnancy loss. Abstract, CDC-Budapest, Hungary, Ist Central and Eastern European Summit on Preconceptional Medicine and Prevention of Birth Defects. 2008 Aug:27-30.
  9. Universal cervical length screening and treatment with vaginal progesterone to prevent preterm birth: a decision and economic analysis. Amer J Obstet Gynecol 2010;202 (6):548.
  10. Universal cervical-length screening and vaginal progesterone prevents early preterm births, reduces neonatal morbidity and is cost saving: doing nothing is no longer an option. Ultrasound Obstet Gynecol 2011;38:1-9.
  11. Universal cervical-length screening to prevent preterm birth: a cost-effectiveness analysis. Ultrasound Obstet Gynecol 2011;38:32-37.
  12. Population-based risk scoring can effectively predict preterm birth risks earlier than cervical length screening followed by fetal fibronectin testing. American Congress of Obstetricians and Gynecologists’ Annual Clinical Meeting, 2012.
  13. Progesterone and preterm birth prevention: translating clinical trials data into clinical practice. Am J Obstet Gynecol 2012;206:376-386.
  14. A guide to the cost of progesterone for prevention of preterm labor. Proc Obstet Gynecol 2011 April;1(3):9.
  15. Available at:‥
  16. Pharmacokinetics and endometrial tissue levels of progesterone after administration by intramuscular and vaginal routes: a comparative study. Fertil Steril 1994;62:485-490.
  17. New hypotheses transvaginal progesterone: evidence for a new functional ‘portal system’ flowing from the vagina to the uterus. Hum Reprod Update 1999;5:365-372.
  18. Preferential vascular-based transfer from vagina to the corpus but not to the tubal part of the uterus in postmenopausal women. Hum Reprod 2001;16;1329-1333.
  19. Intravaginal estrogen and progestin administration: advantages and disadvantages. Best Pract Res Clin Obstet Gynaecol 2008;22:391-405.
  20. Molecular regulation of progesterone secretion by the human corpus luteum throught the menstrual cycle. J Reprod Immunol 2002;55:11-20.
  21. Evolution of noncytotoxic uterine natural killer cells. Am J Reprod Immunol 2008;59:425-432.
  22. Proliferation of uterine natural killer cells is induced by hCG and mediated via the mannose receptors. Endocrinology 2009;150:2882-2888.
  23. Defective production of both leukemia inhibitory factor and type 2T-helper cytokines by decidual T cells in unexplained recurrent abortions. Nat Med 1998;4:1020-1024.
  24. Role of hormone-controlled T-cell cytokines in the maintenance of pregnancy. Biochem Soc Trans 2000;28:212-215.
  25. Defective production of LIF, M-CSF and Th2-type cytokines by T cells at fetomaternal interface is associated with pregnancy loss. J Reprod Immunol 2001;52:35-43.
  26. The preterm prediction study: the value of new vs standard risk factors in predicting early and all spontaneous preterm births. Am J Public Health 1998;88:233-238.
  27. Uterorelaxing effects of vaginal progesterone: comparison of two methodologies for assessing uterine contraction frequency on ultrasound scans. Fertil Steril 2001;76:736-740.
  28. The patterns of uterine contractility in normal menstruating women: from physiology to pathology. Ann NY Acad Sci 2004;1034:64-83.
  29. Effects of vaginal progesterone on pain and uterine contractility in patients with threatened abortion before 12 weeks of pregnancy. Ann NY Acad Sci 2004;1034:200-210.
  30. Greater implantation and pregnancy rates with vaginal progesterone in intracytoplasmic sperm injection but not in in vitro fertilization cycles: a retrospective study. Fertil Steril 2005;83:1391-1396.
  31. Uterine contractility and embryo-implantation. Curr Opin Obstet Gynecol 2006;18:473-484.
  32. Discrete sequential boundaries for clinical trials. Biometrika 1983;70:659-663.
  33. Reduced binding of progesterone receptor to its nuclear response element after human labor onset. Am J Obstet Gynecol 2001;185:579-585.
  34. Mechanisms underlying ‘functional’ progesterone withdrawal at parturition. Ann NY Acad Sci 2004;1034:36-49.
  35. The cytoplasmic 60 kDa progesterone receptor isoform predominates in the human amniochorion and placenta at term. Reprod Biol Endocrinol 2009;7:22.
  36. The luteo-placental shift, the guardian of prenatal life. Postgrad Med J 1969;45:57-64.
  37. Progestin suppresses thrombin and Il-1beta-Induced Interleukin 11. J Clin Endocrinol Metab 2005;90:5279-5286.
  38. Progesterone vaginal gel for the reduction of recurrent preterm birth: primary results from a randomized, double-blind, placebo-controlled trial. Ultrasound Obstet Gynecol 2007;30:687-696.
  39. Prophylactic administration of progesterone by vaginal suppository to reduce the incidence of spontaneous preterm birth in women at increased risk: a randomized placebo-controlled double-blind study. Am J Obstet Gynecol 2003;188:419-424.
  40. Progesterone and the risk of preterm birth among women with a short cervix. N Engl J Med 2007;357:462-469.
  41. Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate. N Engl J Med 2003;348:2379-2385.
  42. Annual summary of vital statistics: Pediatrics 2004;117: 168-183.
  43. Late preterm birth: Beware! Journal Watch Women's Health 2008.
  44. Does cervical cerclage prevent preterm delivery in patients with a short cervix? Am J Obstet Gynecol 2001;184:1325-1329.
  45. Vaginal progesterone in women with an asymptomatic sonographic short cervix in the midtrimester decreases preterm delivery and neonatal morbidity: a systematic review and meta-analysis of individual patient data. Am J Obstet Gynecol 2012;206:124.
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