Efficacy of Prophylactic Progesterone in Prevention of Preterm Delivery in Women with Major Placenta Previa

Abstract

2013, preterm birth was the leading cause of both neonatal mortality (35% of 2.8 million deaths) and child mortality (17% of 6.3 million deaths) worldwide (United Nations Children’s Fund (UNICEF), 2014). Neonates born preterm are at increased risk of both short term complications, attributed to immaturity of multiple organ systems, and long-term adverse health outcomes, such as neurodevelopmental disabilities, behavioral problems, childhood asthma, cardiovascular disease, diabetes and depression, in adult life. In addition, preterm birth is associated with a substantial economic cost and adverse psychosocial and emotional effects on families (UNICEF, 2014). Preterm birth is a syndrome attributable to multiple pathological processes such as infection, vascular disorders, decidual senescence, uterine overdistension, a decline in progesterone action, cervical disease, breakdown of maternal-fetal tolerance and stress, among others (Romero, 2009). The pathophysiology behind unprovoked bleeding in placenta previa is thought to be related to gra