Caiyu Lou1, Caiwen Wang2, Qiang Zhao3, Fenyuan Jin4. 1. Department of Obstetrics and Gynecology, The Sixth People's Hospital of Zhuji Zhuji, Zhejiang Province, China. 2. Department of Traditional Chinese Medicine Gynecology, Gynecology Studio of The Zhus, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine Shanghai, China. 3. Department of Traditional Chinese Medicine Gynecology, Traditional Chinese Medicine Hospital of Zhuji Zhuji, Zhejiang Province, China. 4. Department of Obstetrics and Gynecology, The People's Hospital of Zhuji Zhuji, Zhejiang Province, China.
Abstract
OBJECTIVE: To investigate the efficacy and safety of dydrogesterone and progesterone in the treatment of threatened miscarriage due to corpus luteum insufficiency. METHODS: A prospective cohort study was designed and a total of 1,285 patients with threatened miscarriage due to corpus luteum insufficiency were recruited, in which 665 participants received dydrogesterone treatment (dydrogesterone group), and the other 620 received progesterone treatment (progesterone group). The time for clinical symptom relief, changes of sex hormone levels in serum, the rate of miscarriage prevention, delivery outcome, and adverse effects were compared between the two groups. XGBoost algorithm was applied to analyze the factors impacting the efficacy and safety of each treatment. RESULTS: There was no significant difference regarding the time for clinical symptom relief and the rate of miscarriage prevention between the two groups (P>0.05, RR=1.01, 95% CI: 0.97-1.06, P=0.566). However, after 4 weeks of treatment, compared with the progesterone group, the level of sex hormones was significantly upregulated, while the preterm birth rate (9.65% vs. 14.04%), the postpartum hemorrhage rate (3.10% vs. 5.62%), and the incidence of adverse effects (17.44% vs. 32.58%) were considerably reduced in the dydrogesterone group (all P<0.05). XGBoost algorithm analysis demonstrated that dydrogesterone treatment was correlated with a lower incidence of preterm birth rate, postpartum hemorrhage, and adverse effects, ranking the 3rd, 2nd and 1st, respectively, in the weight of dependent variables. CONCLUSION: Compared with progesterone, dydrogesterone can improve the delivery outcome and demonstrate a higher safety in the treatment of threatened miscarriage due to corpus luteum insufficiency. AJTR
OBJECTIVE: To investigate the efficacy and safety of dydrogesterone and progesterone in the treatment of threatened miscarriage due to corpus luteum insufficiency. METHODS: A prospective cohort study was designed and a total of 1,285 patients with threatened miscarriage due to corpus luteum insufficiency were recruited, in which 665 participants received dydrogesterone treatment (dydrogesterone group), and the other 620 received progesterone treatment (progesterone group). The time for clinical symptom relief, changes of sex hormone levels in serum, the rate of miscarriage prevention, delivery outcome, and adverse effects were compared between the two groups. XGBoost algorithm was applied to analyze the factors impacting the efficacy and safety of each treatment. RESULTS: There was no significant difference regarding the time for clinical symptom relief and the rate of miscarriage prevention between the two groups (P>0.05, RR=1.01, 95% CI: 0.97-1.06, P=0.566). However, after 4 weeks of treatment, compared with the progesterone group, the level of sex hormones was significantly upregulated, while the preterm birth rate (9.65% vs. 14.04%), the postpartum hemorrhage rate (3.10% vs. 5.62%), and the incidence of adverse effects (17.44% vs. 32.58%) were considerably reduced in the dydrogesterone group (all P<0.05). XGBoost algorithm analysis demonstrated that dydrogesterone treatment was correlated with a lower incidence of preterm birth rate, postpartum hemorrhage, and adverse effects, ranking the 3rd, 2nd and 1st, respectively, in the weight of dependent variables. CONCLUSION: Compared with progesterone, dydrogesterone can improve the delivery outcome and demonstrate a higher safety in the treatment of threatened miscarriage due to corpus luteum insufficiency. AJTR
Authors: Adolf E Schindler; Howard Carp; René Druckmann; Andrea R Genazzani; Johannes Huber; Jorge Pasqualini; Karl W Schweppe; Julia Szekeres-Bartho Journal: Gynecol Endocrinol Date: 2015-05-15 Impact factor: 2.260
Authors: Arri Coomarasamy; Helen Williams; Ewa Truchanowicz; Paul T Seed; Rachel Small; Siobhan Quenby; Pratima Gupta; Feroza Dawood; Yvonne E M Koot; Ruth Bender Atik; Kitty W M Bloemenkamp; Rebecca Brady; Annette L Briley; Rebecca Cavallaro; Ying C Cheong; Justin J Chu; Abey Eapen; Ayman Ewies; Annemieke Hoek; Eugenie M Kaaijk; Carolien A M Koks; Tin-Chiu Li; Marjory MacLean; Ben W Mol; Judith Moore; Jackie A Ross; Lisa Sharpe; Jane Stewart; Nirmala Vaithilingam; Roy G Farquharson; Mark D Kilby; Yacoub Khalaf; Mariette Goddijn; Lesley Regan; Rajendra Rai Journal: N Engl J Med Date: 2015-11-26 Impact factor: 91.245