الفهرس 
Placenta PreviaOnly 14 pages are availabe for public view
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Abstract
Background: Placenta previa is a major cause of maternal morbidity and mortality because of the associated massive antepartum and intrapartum hemorrhage. Moreover, placenta previa is associated with preterm delivery, with the neonatal mortality increasing threefold as a result of prematurity. Although placenta previa is associated with antepartum hemorrhage, massive hemorrhage necessitating preterm cesarean section is not observed in all women with the condition.
Aim of the work: The aim of the study is to determine the effect of vaginal progesterone in preventing a second attack of antepartum hemorrhage in pregnant women diagnosed with placenta previa.
Methods: This double-blinded randomized controlled study was performed on total 160 Pregnant women diagnosed with placenta praevia and willing to participate in the study to investigate efficacy of vaginal progesterone in preventing a second attack of antepartum hemorrhage in pregnant women diagnosed with placenta previa at Ain Shams university, Maternity hospital starting from October 2020 till July 2021 with inclusion and exclusion criteria.
Results: Gestational age at 1st attack was 29.73 ± 2.56 weeks in progesterone group and 30.20 ± 2.55 weeks in placebo group. However, after initiation of the vaginal progesterone, the 2nd attack occurred only in 42.5% in progesterone group with prolonged pregnancy and average 5 weeks interval period between the 1st and 2nd attack while in placebo group, the 2nd attack occurred in 77.5% of cases with average 3 weeks interval period between the 1st and 2nd attack with high significant differences between the two groups in GA of 2nd attack and interval between 1st and 2nd attack. There was significant difference between the studied groups regarding the gestational age at the time of delivery as women in progesterone group delivered at GA of 36.05 ± 1.07 weeks while in placebo group, the women delivered at GA of 34.00 ± 3.94 weeks. Neonatal birth weight and APGAR scores were significantly higher in progesterone group. Consequently, NICU admission and neonatal mortality were significantly less among progesterone group.
Conclusion: As evident from the current study, the maintenance tocolysis with vaginal progesterone (at 24–34weeks’ gestation) in placenta previa women appears beneficial in decreasing the number of bleeding attacks, the percentage of Preterm labor and the neonatal ICU admission. So, using vaginal progesterone in expectant management of symptomatic placenta previa tends to be beneficial than placebo. The progesterone successfully prolonged pregnancy in placenta previa patients. As a result, a higher number of term babies, lower number of preterm babies and increased birth weight were reported with progesterone use.
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