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Extra hormone dose could help prevent miscarriages, study finds

Giving pregnant women who have previously had a miscarriage an extra dose of progesterone helps them go on to have a successful pregnancy, researchers say.

Progesterone is produced naturally in the female body and plays an important role in the menstrual cycle and in maintaining the early stages of pregnancy.

A study found that women who have had one or multiple miscarriages and who have early bleeding in their next pregnancy could benefit from extra doses of the hormone.

Researchers from the University of Birmingham said an estimated 4,700 babies could be born that would otherwise be miscarried per year in the UK.

The study did not show that progesterone could help all women who suffered early pregnancy bleeding, but it was found to be of benefit to those who had miscarried previously.


In the largest study of its kind, 4,153 pregnant women who presented with early pregnancy bleeding at 48 UK hospitals were randomly assigned by computer into one of two groups.

The first group, of 2,079 women, were given 400mg of progesterone twice daily as a vaginal pessary. The second, of 2,074, were given a placebo.

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Around 780 women who had previously had one or two miscarriages were given progesterone in the study.

Some 591 (76%) went on to have a live birth, compared with 534 women out of 738 in the placebo group (72%).

Image: An estimated 4,700 babies could be born that would otherwise be miscarried per year in the UK

The effect of the progesterone was greater for the women who had suffered three or more miscarriages, with a 15% increase in the live birth rate in the progesterone group in comparison with those who were given placebos.

Of 137 women with three or more previous miscarriages, 98 (72%) went on to have a live birth, compared with 57% (85 out of 148) of women in the placebo group.

Arri Coomarasamy, professor of gynaecology at the University of Birmingham and director of Tommy's National Centre for Miscarriage Research, said: "The role of progesterone in women with early pregnancy bleeding has been studied and debated for about 60 years, however what we have previously lacked is high-quality evidence."

He added: "Our finding that women who are at risk of a miscarriage because of current pregnancy bleeding and a history of a previous miscarriage could benefit from progesterone treatment has huge implications for practice.

"This treatment could save thousands of babies who may have otherwise been lost to a miscarriage."

The PRISM trial was funded by the National Institute for Health Research (NIHR) and published in the New England Journal of Medicine.

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