A Comparative Study of Vaginal Micronized Progesterone and Oral Dydrogesterone in Threatened Abortion

Introduction: Threatened abortion, characterized by vaginal bleeding and abdominal pain in early pregnancy, requires effective management to improve pregnancy outcomes. Progestogens such as vaginal micronized progesterone and oral dydrogesterone are commonly used, yet limited comparative research exists to inform their optimal use. This study evaluates the efficacy and safety of these treatments in managing threatened abortion. Methods: This prospective observational study, conducted at Saraswathi Institute of Medical Sciences, Hapur, U.P., included pregnant women with clinically and sonographically confirmed threatened abortion (≤24 weeks gestation). Participants were divided into two groups: one receiving 200 mg of vaginal micronized progesterone twice daily and the other 10 mg of oral dydrogesterone twice daily. Data collection included demographic details, bleeding episodes, and obstetric outcomes. Statistical analysis was performed, with significance set at p < 0.05. Results: Baseline characteristics, including age and gestational parameters, were comparable between groups. Pregnancy continuation rates were 89.0% and 84.0% for oral dydrogesterone and vaginal progesterone, respectively (p = 0.30). Adverse effects were similar across groups, with no statistically significant differences. Conclusion: Both oral dydrogesterone and vaginal progesterone demonstrated comparable efficacy and safety profiles in managing threatened abortion. The choice of treatment may depend on patient preferences and clinical circumstances.