COMPARISON OF ROLE OF HUMAN CHORIONIC GONADOTROPIN (HCG) AND PROGESTERONE IN PREVENTING PRETERM LABOR

Background: Preterm labor, defined as delivery before 37 weeks of gestation, remains a significant contributor to neonatal morbidity and mortality worldwide, especially in developing countries. It accounts for over two-thirds of all perinatal deaths and poses ongoing clinical and public health challenges. Pharmacological agents like progesterone and human chorionic gonadotropin (hCG) have been explored for their role in delaying preterm birth, yet area-specific data on their comparative efficacy remains limited. Objective: To evaluate and compare the efficacy of hCG and vaginal progesterone in the prevention of preterm labor in pregnant women at risk. Methods: This randomized controlled trial was conducted at the Department of Obstetrics and Gynecology, Saidu Group of Teaching Hospital, Saidu Sharif, Swat, from July 1st to December 31st, 2024. A total of 174 pregnant women aged 20–40 years, with gestational age between 16 and 36 weeks and parity up to four, were enrolled using non-probability consecutive sampling and randomized into two equal groups. Group A received 200 mg vaginal progesterone daily, and Group B received 5000 IU intramuscular hCG weekly with an adjunctive 100,000 IU infusion. Participants were followed every two weeks until 37 weeks. Data analysis was performed using SPSS version 24. Results: The mean age was 29.98 ± 4.46 years in the progesterone group and 30.67 ± 5.55 years in the hCG group. Preterm labor was prevented in 32 out of 87 patients (35.6%) in the progesterone group, compared to 58 out of 87 patients (64.4%) in the hCG group (p = 0.000), indicating significantly higher efficacy of hCG. Conclusion: hCG was more effective than vaginal progesterone in preventing preterm labor and extending gestation to term in the studied cohort.