COMPARING VAGINAL, ORALAND IM PROGESTERONE TO PREVENT PRETERM LABOUR

Background: Preterm labour (PTL) remains a major contributor to perinatal morbidity and mortality worldwide, with India reporting the highest number of preterm births annually. Progesterone is a key agent in the prevention of PTL, but the optimal route of administration—oral, vaginal, or intramuscular—remains debated. Objective: To compare the efficacy of oral, vaginal, and intramuscular progesterone in preventing PTL among pregnant women at high risk. Methods: An interventional study was conducted over one year at RMCH, Bareilly, including 225 pregnant women divided into three groups (75 each) receiving oral, vaginal, or intramuscular progesterone from 20 weeks 'gestation. Participants were selected via random sampling. Outcomes such as NICU admissions, neonatal complications, and pregnancy duration were assessed across groups, stratified by cervical length and obstetric history. Results: Vaginal progesterone showed the best outcomes in women with a cervical length <25 mm, both in primigravida and in those with previous PTL. Intramuscular progesterone was more effective in those with cervical length >25 mm and a prior PTL history. Oral progesterone was associated with higher NICU admissions and more side effects. Conclusion: Vaginal and intramuscular progesterone are more effective than oral progesterone in PTLprevention. The route should be individualized based on clinical parameters.