Life

Ask The Expert: how can I reduce the risk of early miscarriage?

A gynaecologist from the baby charity Tommy's explains how taking progesterone could help some pregnant women prevent recurrent early miscarriage

Bleeding during pregnancy can be extremely worrying
Lisa Salmon

I'VE had a miscarriage before and have just started bleeding at six weeks of pregnancy. Is it true that taking progesterone might help me avoid another miscarriage?

Gynaecologist Professor Arri Coomarasamy, director of Tommy's National Centre for Miscarriage Research, was the chief investigator for the recent PRISM trial which studied the effects of progesterone in women with early pregnancy bleeding.

He says: "If you've started bleeding at six weeks of pregnancy, you should seek medical assistance as soon as possible by visiting a specialist Early Pregnancy Assessment Unit or A&E at your nearest hospital.

"Bleeding before 12 weeks can happen for about 20 per cent of pregnant women and although women are often worried at the sight of blood, it's not always a sign of a problem.

"Progesterone is natural hormone made by the body that's vital to support a pregnancy. We've recently conducted a large trial to test if giving progesterone to women suffering from early pregnancy bleeding (also known as threatened miscarriage) during the first 12 weeks can prevent a miscarriage.

"This was a very high quality study, with patients receiving either progesterone or a dummy drug (placebo), and neither the patient nor their doctor knew what treatment they were taking.

"Our research found vaginal progesterone is able to prevent miscarriage in women with early pregnancy bleeding and a history of previous pregnancy loss.

"For women who had no previous history of pregnancy loss, 74 per cent who were treated with progesterone went on to have a baby, compared with 75 per cent who were treated with placebo. However, for women with a history of pregnancy loss, 75 per cent who were treated with progesterone went on the have a baby, compared with 70 per cent who were treated with placebo.

"These differences were even bigger in women with a history of multiple miscarriages – for example, in women with a history of three or more previous miscarriages, 72 per cent who were treated with progesterone went on the have a baby, compared with 57 per cent who were treated with placebo.

"This evidence indicates progesterone could be an effective treatment to prevent miscarriages in women who've had a miscarriage before and bleeding in the current pregnancy. You should ask the hospital doctor about prescribing you vaginal progesterone for up to 16 weeks of pregnancy."

:: More information about the PRISM trial can be found on the Tommys.org website

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