Non-interventional Study of Therapy for Threatened Miscarriage
Condition: Threatened Miscarriage
MeSH terms: Abortion, Spontaneous; Abortion, Threatened
Study type: Observational

Summary: 
      Study the efficacy and safety of therapy for threatened miscarriage with medicinal products
      Utrogestan (micronized progesterone), 200 mg capsules (Besins Healthcare SA, Belgium), and
      Duphaston (Dydrogesterone), 10 mg coated tablets (Abbott Healthcare Products B.V., the
      Netherlands)
    

Detailed description: 
      Open comparative non-interventional study.

      During the study three visits are planned:

      Visit 1 (enrollment) is conducted when the patient is hospitalized in a hospital (providing
      medical care to pregnant women diagnosed with threatened miscarriage) due to the threat of
      miscarriage when the inclusion/exclusion criteria are met (women aged 18-35 years with a
      confirmed threat of miscarriage with a gestation period of 8 to 22 full weeks). Depending on
      the chosen therapy tactics (this therapy is routine in Russia), all patients are allocated to
      one of the three study groups:

      Group I receives Utrogestan (micronized progesterone), 200 mg orally thrice a day until acute
      symptoms of the threat of termination of pregnancy (scarlet discharge from the genital tract,
      pain in the abdomen) and then Utrogestan vaginally 200 mg twice a day and 200 mg orally once
      a day before bed; Group II receives Utrogestan (micronized progesterone) vaginally 200 mg
      twice a day and 200 mg orally once a day before bed; Group III receives Duphaston
      (Dydrogesterone), orally 40 mg once, then 10 mg every 8 hours until the symptoms disappear.

      Visit 2 (on the third day of the study/hospitalization). If pregnancy is interrupted earlier,
      Visit 3 is made.

      Visit 3 (on the day of discharge from the hospital: with prolonged or interrupted pregnancy)

      Routine clinical procedures (accepted in Russia) will be performed during the study:

        -  Collection of demographic and anthropometric data (age, height, body weight);

        -  Collection of complaints, medical and obstetric-gynecological history;

        -  Measurement of blood pressure, heart rate, respiratory rate and body temperature;

        -  Gynecological examination with the help of gynecological specula;

        -  Vaginal bimanual examination;

        -  Transvaginal ultrasound, determination of viability of uterine pregnancy (determination
           of embryo/fetal heartbeat);

        -  Assessment of the severity of the patient's condition according to Clinical Global
           Impression scale;

        -  Evaluation of psycho-emotional status dynamically using Zigmond-Snaith Hospital Anxiety
           and Depression Scale;

      Efficacy will be evaluated using primary and secondary efficacy endpoints.

      Primary efficacy endpoint:

      • Discharge from the hospital with prolonged pregnancy;

      Secondary efficacy endpoint:

        -  Speed of arrest of symptoms of threatened miscarriage (blood discharge from the genital
           tract and drawing pains in the lower abdomen);

        -  Duration of hospitalization;

        -  Severity of patient's condition dynamically in the course of therapy;

        -  Psycho-emotional status of women dynamically in the course of therapy;

      Criteria for safety evaluation:

      • Evaluation of AE/SAE. All adverse events (As) and serious adverse events (SAE) will be
      recorded, starting from the moment of signing of informed consent before the end of
      participation in the study (before discharge from the hospital).
    

Intervention name(s): Micronized progesterone; Micronized progesterone; Dydrogesterone
Intervention type(s): Drug; Drug; Drug
Intervention description(s): Utrogestan, 200 mg orally thrice a day until acute symptoms of the threat of termination of pregnancy (scarlet discharge from the genital tract, pain in the abdomen) and then Utrogestan vaginally 200 mg twice a day and 200 mg orally once a day before bed; Utrogestan vaginally 200 mg twice a day and 200 mg orally once a day before bed; Duphaston, orally 40 mg once, then 10 mg every 8 hours until the symptoms disappear
Other intervention name(s): Utrogestan; Utrogestan; Duphaston
Intervention MeSH terms: Progesterone; Dydrogesterone
Observational model: Other
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Women aged 18-35 years with a confirmed threat of miscarriage with a gestation period of 8
        to 22 full weeks.
      
Keywords: threatened miscarriage; miscarriage; micronized progesterone; dydrogesterone