Management of threatened miscarriage and recurrent miscarriage: guidance on use of progesterone
The Progesterone Pathway ensures that women who have had at least one previous miscarriage and present with early pregnancy bleeding are offered vaginal micronised progesterone, where it is clinically indicated, and provides guidance on asymptomatic women with four or more previous miscarriages.
Follow up after treatment with progesterone is initiated
No extra follow up is required for eligible women who opt to use vaginal micronised progesterone for threatened miscarriage with a history of one or more miscarriages, if they are known to have a viable pregnancy at treatment initiation. Their usual antenatal care booking should proceed as normal. Women should be advised to stop vaginal micronised progesterone treatment by 16 weeks’ gestation.
For women using vaginal micronised progesterone who commence treatment when viability of the pregnancy is not certain, it is good practice to repeat an ultrasound scan for viability 1 to 2 weeks after commencement of progesterone.