Role of dydrogesterone in the treatment of idiopathic IUGR

Abstract

Background: a) To evaluate the therapeutic efficacy of dydrogesterone in the treatment of pregnant women with idiopathic fetal growth restriction. b) To compare the outcome with the control group receiving conventional treatment in the form of rest and high protein diet.

Methods: Pregnant women with idiopathic IUGR between 28-34 weeks gestation were randomized to either

Group 1: Control group receiving conventional treatment in the form of rest and high protein diet (n=41).

Group 2: Study group receiving dydrogesterone (n=43)

Primary outcome were compared in terms of fetal birth weight, apgar at birth, perinatal morbidity and mortality. Secondary outcomes in terms of changes in Doppler indices, gestational age at delivery, requirement for inductions, need for cesarean sections for IUGR, fetal distress in labour were compared.

Results: Average fetal birth weight in kg were (1.71± 0.37 vs 2.03 ± 0.4, p=S), poor apgar scores (29.3% vs 20.9%, p=NS), nursery admissions (46% vs 18.6%, p=S), perinatal mortality (7.3% vs 4.7%, p=NS) in the control and study group respectively. Average gestational age at delivery was 36.4± 2.34 vs 36.9 ± 1.93 weeks (p=NS) in the control and study group respectively. Labour inductions were similar and cesarean section rates were significantly more in the control group as compared to the study group  receiving dydrogesterone (39% vs 23.3%, p=S).

Conclusion: Dydrogesterone for the treatment of IUGR looks promising as it favourably affects the fetal birth weight and nursery stay.