Assessment of the Immunomodulatory Role of Dydrogesterone in Preventing Pregnancy Loss in Threatened Abortion

Objective: To assess the immunomodulatory role of Dydrogesterone in preventing pregnancy loss in cases of threatened abortion. Materials and methods: This were a prospective interventional study that included two groups each included 16 women. Group 1 included 16 pregnant women presented with symptoms of threatened abortion, and group 2 that included 16 health females with normal pregnancy. All of the studied females were subjected to complete clinical assessment. Laboratory assessment of serum levels of IL-4 (Marker of T-helper 2), IFN γ (Marker of T-helper 1) and serum progesterone level were done for all participants. All women in group 1 were treated with certain doses of Dydrogesterone while women in control group were not allowed to use any form of progesterone. Participants were assessed for IL-4, IFN-γ and progesterone after treatment. Also continuing pregnancy rates were calculated. Results: Both groups were matched as regarding patients’ characteristics and baseline parameters. Dydrogesterone has resulted in significant decrease of Th1/Th2 ratio with shift from Th1 predominance to Th2 predominance. Continuing pregnancy rate in the threatened abortion group was 93.8%. Conclusion: Dydrogesterone is useful in the treatment of threatened abortion via modulating cytokine profile and causing shift in Th1/Th2 ratio for Th2 predominance and more specifically via decreasing level of Th1 markers as IF-γ.