ROLE OF ORAL PROGESTERONE FOR MAINTENANCE TOCOLYSIS AFTER INITIAL MANAGEMENT OF PRETERM LABOUR

Abstract

Background: Premature labor that is characterized as a labor beginning before 37 weeks of gestation period is one of the major causes of morbidity and mortality among newborns in every part of the world. Tocolysis during maintenance after successful arrest of preterm labor is meant to extend pregnancy and to have more positive neonatal outcomes. Progesterone has been explored as a possible agent to use in maintenance therapy, but its effectiveness has proved inconsistent among different populations. Objective: To define the outcome of maintenance with oral progesterone tocolysis following initial management of the preterm labor. Methodology: The study was a descriptive longitudinal study done in the Department of Obstetrics and Gynecology at Sughra Shafi Medical Complex, Narowal from October 2025 to February 2026. Non-probability consecutive sampling was used to enroll 150 pregnant women aged 1840 years whose gestational age was above 32 weeks of pregnancy and had preterm labor. Following first line tocolytic care as per the conventional standards, patients administered 400 mg oral progesterone one time a day at nighttime to maintain tocolysis. Fetal corticosteroids (6 doses of 12 mg dexamethasone, administered intramuscularly every 12 hours) were also administered. Follow up of patients was to deliver. Outcomes were term delivery (37 weeks or more) and gestational age prolongation (days between therapy initiation and delivery). Data analysis was conducted using SPSS version 25. Results: Of 150 women who were enrolled in the study, mean maternal age was 28.4 years, standard deviation of 4.8 and mean gestational age at presentation 33.8±1.4 years. There was term delivery in 92 (61.3%) patients. The average extension of pregnancy term was 41.7±12.5 days. Delivery through vaginal birth was done in 98 (65.3%) patients and 52 (34.7%) patients had cesarean delivery. Conclusion: Oral progesterone seems to be a viable alternative during maintenance tocolysis following initial care of the preterm labor which greatly extends the pregnancy period and improves chances of a full-term birth. The resource-limited settings may benefit by using it to minimize complications of prematurity.