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Hopes for prevention of miscarriage with progesterone treatment

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Under new NHS guidelines, women who are deemed to be at high risk of miscarriage will be offered progesterone treatment.

The National Institute for Health and Care Excellence (NICE) has published updated guidance on miscarriage following a research trial. The charity Tommy’s has estimated that there could be 8,450 more successful births each year in the UK and NICE has suggested that roughly 1,200 women could be eligible for progesterone treatment each year.  

Progesterone is a naturally occurring hormone made by the body. It helps the uterus grow during pregnancy and stops it from having contractions, which can be the cause of early bleeding in pregnancy. Bleeding within the first 12-13 weeks of pregnancy (the first trimester) is quite common and is not always a problem – however it can be a sign of miscarriage or impending miscarriage. 

The updated NICE guidance recommends a 400mg micronized progesterone pessary twice a day. This guidance is based on the outcome of the PRISM trial which showed that the treatment benefits women who had early pregnancy bleeding and had previously suffered a miscarriage. 

This treatment is most effective for women who have previously suffered a miscarriage and therefore the following criteria has been developed by NICE. 

The criteria for being offered this treatment is that the mother must: 

  • have suffered a previous miscarriage
  • have a pregnancy confirmed by scan
  • be suffering bleeding

If a fetal heartbeat is confirmed then it is recommended that this treatment should continue until 16 weeks of pregnancy. The treatment cannot prevent every miscarriage and NICE has called for more research in this area – however this is an important step forward in preventing the trauma of suffering a miscarriage.

Sue Prior, partner at Shoosmiths’ Thames Valley office in Reading, says:

“Many women suffer the traumatic experience of multiple miscarriages when trying for a family. Hopefully, this research and the new NICE guidance will mean that many more women are able to successfully carry their pregnancy to term. Bleeding and cramping in early pregnancy can also be a sign of ectopic pregnancy and so women with any of these signs should contact their doctor for further investigation.”

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Disclaimer

This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2022

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