Pregnant women at risk of miscarrying will be prescribed a hormone therapy on the NHS that could lead to thousands more births every year.
Britain’s health watchdog has approved progesterone for expectant mothers who have previously had a miscarriage and are experiencing spotting or bleeding.
The National Institute of Health Care (NICE) made the approval based on research which found the therapy could prevent 8,450 miscarriages in the UK each year.
Under the new guidance, women with previous history of miscarriage in the early stages of new pregnancy and who are experienced vaginal bleeding will be given two 400mg daily doses of progesterone.
The hormone has been used for decades as a contraceptive, as well as to lessen the symptoms the menopause, but at different dosages.
Women with a prior history of miscarriage and who are experiencing bleeding in the early stages of their new pregnancy will now be prescribed a new hormone treatment that could boost their chance of having a live birth by between 5-to-15 per cent according to studies (stock image)
Progesterone is a natural hormone the body produces during pregnancy. During pregnancy it helps grow the lining of the womb and helps the mother’s body accept the growing baby.
When used as a contraceptives progesterone thickens mucus in the cervix, making it is harder for sperm to penetrate the womb and reach an egg.
Progesterone is also used to help alleviate symptoms of the menopause such as hot flushes, night sweats, and vaginal dryness, alongside other replacement hormones that women’s bodies struggle to produce as it undergoes the process.
Under the new guidance for pregnant women at-risk of miscarrying, two 400mg doses are inserted into the vagina every day via a pessary, a soft flexible device.
If the fetal heartbeat is detected in a subsequent scan the progesterone treatment will be continued until the end of week 16 of the pregnancy.
NICE made its new recommendation after an examination of two trials into the use of progesterone in pregnancy, one held in both the UK and the Netherlands, and one that was only held in the UK.
What is progesterone and how does it work?
Progesterone is a natural hormone the female body produces during pregnancy and at other times in the reproductive cycle.
It has a number of applications depending on when it is used and at what dosage.
In pregnancy it helps grow the lining of the womb and helps the mother’s body accept the growing baby.
Progesterone is produced by the corpus luteum, a temporary mass of cells that forms in an ovary during the menstrual cycle.
It has been also been prescribed as a contraceptive for decades.
When used in this way, it thickens the mucus of the cervix to prevent sperm reaching an egg.
It’s also used as hormone replacement therapy to treat the menopause.
The UK based study, which was the larger of the two, involved 4,153 women who were experiencing early pregnancy bleeding, found a 5 per cent increase in the number of babies born in the women who had previously had a miscarriage.
The benefit was even stronger for women who previously had multiple miscarriages, with women who had lost three or more babies having a 15 per cent increase in live births.
No benefit was observed for women who had never had a miscarriage.
The research was led by the University of Birmingham and pregnancy charity Tommy’s National Centre for Miscarriage Research.
A separate study estimated the cost of providing two 400mg doses of progesterone a day to be £204, on average, per pregnancy.
About one in five pregnant women experience bleeding in their first 12 weeks of pregnancy.
Two in three of these women will continue their pregnancy but the other will suffer a miscarriage.
Recurrent miscarriages, defined as three in a row, are rare, only affecting one in 100 women.
There are an estimated 250,000 miscarriages in the UK each year, with most cases occurring in the first three months of pregnancy. In the vast majority of cases no specific cause of the miscarriage can be identified.
Suffering a miscarriage can be emotionally devastating for both pregnant women and their partner, and those who go through the experience are encouraged to seek support and help.
Any women experiencing bleeding in early pregnancy should call their early pregnancy unit and ask to be seen. If the unit is closed they should visit A&E as soon as possible.
How at least one in five pregnancies ends in a miscarriage
One in five pregnancies in women who know they are pregnant become miscarriages.
But even more happen among women who don’t know they have conceived.
Miscarriage occurs when a pregnancy is lost within the first 23 weeks after conception.
The main symptoms are bleeding from the vagina, which may be accompanied by lower abdominal pain.
There are various reasons women may have a miscarriage – it is common and is not usually caused by something they have done.
If a miscarriage happens in the second trimester – between weeks 14 and 26 – it may be a sign of an underlying problem.
Often, miscarriages are isolated events and women will go on to have successful pregnancies.
The majority of miscarriages can’t be prevented, although being generally healthy will help reduce the risk.
Losing three or more pregnancies in a row – known as recurrent miscarriages – is uncommon but still affects around one in 100 women.