Hope for many couples as progesterone shown to reduce risk of miscarriage in some women
The PRISM trial, funded by the NIHR and co-ordinated in the University of Birmingham in collaboration with Tommy’s National Centre for Miscarriage Research, is the largest ever trial of its kind and involved 4,153 pregnant women who presented with early pregnancy bleeding.
The women were randomly assigned by computer into one of two groups – one group of 2,079 women were given progesterone, while the other group of 2,074 women were given a placebo.
While the research did not show statistically strong enough evidence to suggest that progesterone could help all women who are suffering early pregnancy bleeding to go on to have a baby, importantly the results did show the hormone benefited those who had early pregnancy bleeding and had previously suffered a miscarriage.
The overall live birth rate was 75% (1513/2025) in the progesterone group and 72% (1459/2013) in the placebo group. That 3% difference in live birth was not ‘statistically significant’ – meaning that the difference could have been due to chance.
However, when the results were split by the number of previous miscarriages that the participants had suffered, the analysis showed that:
• No previous miscarriages: the live birth rate was 74% (824/1111) in the progesterone group and 75% (840/1127) in the placebo group, i.e. no benefit
• 1-2 previous miscarriages: the live birth rate was 76% (591/777) in the progesterone group and 72% (534/738) in the placebo group, i.e. some benefit
• 3 or more previous miscarriages: the live birth rate was 72% (98/137) in the progesterone group and 57% (85/148) in the placebo group, i.e. substantial benefit
Leanne had three miscarriages – each one traumatic in its own way. After her second loss, Leanne had support from her mum and her husband John, but she had started withdrawing from others, particularly her brother and sister-in-law who had just had a baby.
“I found myself in a very dark place. I had chosen to keep my losses a secret from everyone. I started to make excuses not to go to family events. I missed my niece’s christening. In a cruel way my miscarriages started to rule my life.”
Leanne’s GP put her in touch with Tommy’s National Centre for Miscarriage Research, led by Professor Quenby, consultant obstetrician at University Hospitals Coventry and Warwickshire.
“As soon as I walked into the clinic, it felt like being part of a family who understood what I was going through.”
Diagnosed with a blood clotting disorder, Leanne agreed to participate in a randomised clinical trial. Despite experiencing a third miscarriage, she was given the support and care she needed to persist in her dream of becoming a mother. She became pregnant again and, at 32 weeks, allowed herself to tell the wider family, and some friends, the good news. Professor Quenby’s team did everything to reassure her and provide support every step of the way, including monitoring and scans twice to three times a week.
Paisley was born on 1st March 2018. After so many heart-wrenching disappointments, it wasn’t easy for her to bond with her daughter. She had an overwhelming sense of guilt about the babies she had lost and a fear that everything would go wrong again, but when Paisley was three months old, that all changed.
“At three months old I had this wave of emotion come over me. The love I felt for Paisley that was impossible to describe … I enjoy everything about motherhood. My family and I will never be able to thank enough Professor Quenby and her staff, Tommy’s and the UHCW for everything they have done for us. They have made our lives complete and for that we will be forever grateful.”
Thank you for supporting Tommy's and for enabling us to be able to give families like Leanne & John's happy, healthy babies to take home.