According to the International Federation of Gynecology and Obstetrics (FIGO), as many as one in four pregnancies ends in miscarriage and vaginal bleeding in early pregnancy is associated with a one in three risk of a miscarriage. The numbers are grave and yet, disclosure is lacking - the common miscarriage is barely spoken of. Prevalent as it may be, the effect of its silence has been linked to post-traumatic stress disorder (PTSD), which only recently is being exposed. Fortunately, a new study shows a hormone may reduce the chance of miscarriage in women.
There is a vital connection between progesterone and pregnancy. The hormone, which is naturally produced by women, plays a critical role - prior to and during pregnancy. Progesterone has been shown to help stabilize the inner lining of the uterus - the endometrium- an important factor for healthy embryo development.
The PRISM trial, funded by the National Institute for Health Research (NIHR) and coordinated by Birmingham Clinical Trials Unit in collaboration with Tommy's National Centre for Miscarriage Research, is the largest ever trial of its kind and involved 4,153 pregnant women who presented with early pregnancy bleeding.
The women, who were being treated at 48 hospitals across the UK, were randomly assigned by computer into one of two groups. In the first group, 2,079 women were given progesterone, while in the other group, 2,074 women were given a placebo.
The results of the PRISM trial revealed, that although the treatment did not reduce the rate of miscarriage for those with no previous miscarriages, there was a small reduction in miscarriage for those with 1-2 previous miscarriages and a big reduction in miscarriage for those with 3 or more previous miscarriages. There was a 15% increase in the live birth rate - with 98 out of 137 women going on to have a baby, compared with 85 out of 148 in the placebo group. The data confirms that for women experiencing bleeding in their current pregnancy and who have had one or more miscarriages, progesterone treatment is favorable.
Women can self-administer these treatments, and they are usually covered by insurance, says Dr. Stephenson. Before deciding on a treatment option, she cautions, patients should undergo a thorough evaluation to determine what strategies might work for them.