title: Comparative Study of Vaginal versus Intramuscular Progesterone in the Prevention of Preterm Delivery: A Randomized Clinical Trial.
abstract: BACKGROUND
  Preterm birth is a worldwide health concern due to its various negative consequences. Therefore, the prevention of preterm birth is a top priority for healthcare systems in all countries.
  
  
  OBJECTIVE
  To compare the effectiveness of vaginal versus intramuscular progesterone in the prevention of preterm delivery.
  
  
  METHODS
  This randomized clinical trial was conducted at Shahid Sadoughi Hospital in Yazd, Iran, from November 21, 2012 to January 20, 2015. Seventy-eight pregnant women with singleton pregnancy and one risk factor of preterm delivery were included in the study. The subjects were assigned randomly to two groups, with group one receiving Cyclogest and group two receiving 17-α hydroxyprogesterone caproate. Subsequently, we analyzed drug complications during pregnancy, delivery time, neonatal outcomes, and patients' satisfaction among the two groups. The data were analyzed using SPSS version 16. We used descriptive statistics, chi-squared, t-test, and ANOVA for the analyses of primary and secondary outcomes.
  
  
  RESULTS
  Among the 39 births in group one, 33.3% occurred preterm, and, among the 39 births in group two, 30.7% occurred preterm (< 37 weeks). The mean gestational ages at delivery in groups 1 and 2 were 37.07 ± 2.23 and 36.81 ± 2.77 weeks, respectively (p = 0.765). Other variables were not significantly different between the two groups, including birth weight (p = 0.745), Apgar scores for the first and fifth minutes (p = 0.574, 0.630), length of stay in the neonatal intensive care unit (NICU) when the newborns needed hospitalization (p = 0.358), and the patients' satisfaction with the drugs that were used (p = 0.615).
  
  
  CONCLUSIONS
  In this study, vaginal progesterone and intramuscular progesterone had the same levels of effectiveness, safety and acceptance by patients in the prevention of preterm delivery. Therefore, both can be used for this purpose in clinical practices, but more studies are needed.
authors.affiliation: M.D., Obstetrician & Gynecologist, Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Afsar Sadat Tabatabaei
authors.initials: AS
authors.lastname: Bafghi
authors.affiliation: M.D., Obstetrics & Gynecology Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Bahrami
authors.affiliation: M.D., Obstetrician & Gynecologist, Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Sekhavat
keywords: pregnancy; preterm delivery; progestins