title: A pilot study to determine whether progestogen supplementation using dydrogesterone during the first trimester will reduce the incidence of gestational hypertension in primigravidae.
abstract: BACKGROUND
  Gestational hypertension (GH) remains one of the main causes of high maternal and perinatal morbidity and mortality worldwide with the highest incidence among primigravidae of about 10%-15%. However, it was noted that the incidence of GH in primigravidae who conceived following assisted reproductive technique (ART) or intrauterine insemination (IUI) supplemented with dydrogesterone during the first trimester was low.
  
  
  OBJECTIVE
  To determine whether dydrogesterone supplementation during the first trimester can reduce the incidence of GH among primigravidae.
  
  
  METHODS
  A prospective cross-sectional comparative study was undertaken in 2010 on 116 primigravidae (study group) who conceived following ART or IUI and supplemented with dydrogesterone up to 16 weeks gestation. They were matched for age and race at 16 weeks gestation with a control patient from the early pregnancy clinic who were primigravidae (n = 116) who conceived spontaneously without dydrogesterone supplementation.
  
  
  RESULTS
  The incidence of GH in the study group was significantly lower than the control group (1.7% versus 12.9%, p = 0.001). The incidence of fetal distress was also significantly lower in the study group compared to the control group (4.3% versus 18.1%, p = 0.001).
  
  
  CONCLUSIONS
  Dydrogesterone supplementation during the first trimester significantly reduced the incidence of GH and fetal distress in primigravidae.
authors.affiliation: Department of Obstetrics and Gynaecology.
authors.forename: M R
authors.initials: MR
authors.lastname: Zainul Rashid
authors.forename: Jing Fen
authors.initials: JF
authors.lastname: Lim
authors.forename: Noorfaizahtul Hanim M
authors.initials: NH
authors.lastname: Nawawi
authors.forename: Melissha
authors.initials: M
authors.lastname: Luqman
authors.forename: Muhammad Faizuddin
authors.initials: MF
authors.lastname: Zolkeplai
authors.forename: Harry Surya
authors.initials: HS
authors.lastname: Rangkuty
authors.forename: Natasha Ain
authors.initials: NA
authors.lastname: Mohamad Nor
authors.forename: Azmi
authors.initials: A
authors.lastname: Tamil
authors.forename: Shamsul Azhar
authors.initials: SA
authors.lastname: Shah
authors.forename: Seong Wai
authors.initials: SW
authors.lastname: Tham
authors.forename: A E
authors.initials: AE
authors.lastname: Schindler
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004394:Dydrogesterone / Q000627:therapeutic use*; D005260:Female; D005316:Fetal Distress / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D020073:Gravidity; D006785:Hospitals, University; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology / Q000208:ethnology / Q000503:physiopathology / Q000517:prevention & control*; D015994:Incidence; D007247:Infertility, Female / Q000628:therapy; D007315:Insemination, Artificial; D008296:Malaysia / Q000453:epidemiology; D010044:Outpatient Clinics, Hospital; D010865:Pilot Projects; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011372:Progestins / Q000627:therapeutic use*; D011446:Prospective Studies; D027724:Reproductive Techniques, Assisted
chemical_list: D011372:Progestins; D004394:Dydrogesterone