مقایسه تأثیر قرص دیدروژسترون و شیاف پروژسترون در تهدید به سقط جنین

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استاد گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 دستیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

10.22038/ijogi.2025.87998.6435

چکیده

مقدمه: با توجه به اهمیت و شیوع نسبتاً بالای تهدید به سقط جنین و عدم وجود روش پیشگیرانه کاملاً اثبات ­شده برای این اختلال که اغلب با عوارض متعدد همراه است، مطالعه حاضر با هدف مقایسه میزان بقای بارداری و اثر دو داروی پروژسترون واژینال و دیدروژسترون خوراکی بر تهدید به سقط انجام شد.
روشکار: این مطالعه­ نیمه ­تجربی در سال 1403-1401 بر روی ۶۲ زن باردار مبتلا به تهدید به سقط مراجعه­ کننده به بیمارستان ­های آیت­الله طالقانی و امام حسین (ع) تهران انجام شد. افراد در دو گروه بررسی شدند. یک گروه دیدروژسترون خوراکی و گروه دیگر شیاف پروژسترون دریافت کرده و تعداد روزهای خونریزی واژینال، حجم خونریزی، نرخ سقط، عوارض دارویی و سطح پروژسترون خون بین دو گروه مقایسه شد. تجزیه و تحلیل داده ­ها با استفاده از نرم ­افزار آماری SPSS (نسخه ۲۵) و آزمون کای دو انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ ها: در گروه دیدروژسترون خوراکی نسبت به گروه شیاف پروژسترون، مدت خونریزی واژینال پس از مطالعه (58/2±26/6 در مقابل 29/5±68/10 روز؛ 001/0>p)، شیوع سقط جنین (1/16% در مقابل 7/38%؛ 046/0=p) و عدم تداوم بارداری (4/19% در مقابل 8/54%؛ 004/0=p)، به ­طور معنی­ داری کمتر و درصد رضایت­ مندی بالاتر بود (6/22% در مقابل 2/3%؛ 001/0>p).
نتیجه ­گیری: با توجه به اثربخشی بالا، دسترسی مناسب، عوارض بسیار محدود و رضایت ­مندی بیشتر، تجویز دیدروژسترون خوراکی در موارد تهدید به سقط نسبت به فرم واژینال پروژسترون ارجحیت دارد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

The Effects of Dydrogesterone Tablet vs. Progesterone Suppositories on Threatened Abortion

نویسندگان [English]

  • Fakhrolmolouk Yasaei 1
  • Fatemeh Nikbakht Dana 2
1 Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Considering the importance and relatively high prevalence of cases of threatened abortion and the fact that there is still no completely proven preventive method for this disorder that are mostly associated with many complications, this study was conducted with aim to compare pregnancy continuation rates and the efficacy of vaginal progesterone versus oral dydrogesterone in threatened miscarriage.
Methods: This semi-experimental study was conducted in 2022-2024 on 62 pregnant women with threatened miscarriage referred to Ayatollah Taleghani and Imam Hossein (AS) Hospitals in Tehran. Participants were allocated into two comparative groups: one receiving oral dydrogesterone and the other administered vaginal progesterone suppositories. Vaginal bleeding duration, bleeding volume, miscarriage rates, drug-related adverse effects, and serum progesterone levels were compared between the two groups. Data analysis was performed using SPSS software (version 25) and Chi-square test. P<0.05 was considered significant.
Results: In women of the oral dydrogesterone group compared to the progesterone suppository group, the duration of vaginal bleeding after the study (6.26 ± 2.58 vs. 10.68 ± 5.29 days, P<0.001), Prevalence of miscarriage (16.1 vs. 38.7%, P=0.046) and non-continuation of pregnancy (19.4 vs. 54.8%, P=0.004) was significantly lower and the percentage of satisfaction was higher (22.6 vs. 3.2%, P<0.001).
Conclusion: Due to high effectiveness, proper access, very limited side effects and high satisfaction, administration of oral dydrogesterone in cases of threatened abortion is more preferable than vaginal form of progesterone.

کلیدواژه‌ها [English]

  • Dydrogesterone
  • Progesterone
  • Threatened Abortion
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