الفهرس 
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Abstract
Preterm birth is the single biggest cause of neonatal mortality and morbidity worldwide.
Worldwide in 2010 an estimated 14.9 million neonates were born preterm of whom 1.6 million were born<32 weeks of gestation.
Babies born preterm that is, before 37+0weeks of pregnancy have high rates of early, late and post neonatal mortality, with the risk of mortality being inversely proportional to gestational age at birth. Babies who survive have increased rates of disability compared with babies who are not born preterm.
The major long term consequence of prematurity is neuro developmental disability. This can range from severe motor abnormalities, such as cerebral palsy, through to less severe cognitive abnormalities.
Although the risk for the individual child is greatest for those born at the earliest gestations, the global burden of neurodevelopmental disabilities is driven by the number of babies born at each of these gestations, and is therefore greatest for babies born between 32 and 36 weeks, less for those born between 28 and 31 weeks, and least for those born at less than 28weeks’ gestation.
Prevention is directed towards identification of women at risk recent studies have identified clinical, sonographic, and biochemical markers that help to identify the women at highest risk. Determining cervical length and measuring cervicovaginal fibronectin have been proposed as useful tools for evaluating women at risk of preterm birth and may identify those who might benefit from antenatal corticosteroids, but effective interventions to prevent preterm birth remain elusive.
Several trials have shown a reduction in spontaneous PTB using various formulations of Progesterone, Natural (micronized) Progesterone is identical to the Progesterone produced by the placenta and corpus luteum and so is readily metabolized and associated with minimal side effects.
Because of the multiple roles of Progesterone in the establishment and maintenance of pregnancy, it has been a natural choice for the treatment and prevention of preterm Labor. Multiple trials have examined the use of progesterone in various preparations for prophylaxis against recurrent preterm birth, which have proved a protective effect of progesterone with a significantly longer mean duration of pregnancy, higher mean birth weight, and lower perinatal mortality rate.
Both the American College of Obstetricians and Gynaecologists and the Canadian Society of Obstetrics and Gynaecology endorse the use of progesterone prophylaxis in selected women.
Randomized controlled trials and meta analysis have demonstrated that low-dose aspirin initiated before 16 weeks’ gestation is associated with a significant decrease of preeclampsia and intrauterine growth restriction, and most likely the severe and preterm forms of these diseases
Four hundred (400) pregnant women were admitted. follow up data were available for 240 women and randomly arranged in two groups (progesterone and low dose aspirin group or progesterone and placebo group) 120 women in each group.120 women received low dose aspirin once daily initiated from 14 weeks of gestation to 34 weeks of gestation with 17 OHPC once weekly from 24w to 34w of gestation. Another 120 pregnant femalereceived placebo from 14 weeks of gestation to 34 weeks of gestation with 17 OHPC once weekly from 24w to 34w of gestation.
Primary outcome measure was preterm birth, defined as birth at a GA of less than 37 weeks. The most important secondary outcome is a composite of poor neonatal outcome (including bronchopulmonary dysplasia (BPD), periventricular leucomalacia, intraventricular hemorrhage, necrotizing enterocolitis, retinopathy of prematurity (ROP), sepsis and perinatal death).
There was no statistically significant difference between both groups as regarding to age, duration of marriage, gravidity, parity, body mass index, mean cervical length, and number of previous preterm labor.
There was no significant difference between two groups as regard preterm premature rupture of membranes (P.PROM).
There was no significant difference between two groups as regard time of delivery there was no significant difference between both groups in Need for NICU admission, neonatal birth weight, APGAR score, fetal complications (RDS, jaundice, BPD, HIE, NEC, bleeding, sepsis or even neonatal death).
Long term neurodevelopmental complications was not conducted at this study as it needs more time.
In maternal complications there was no significant difference between both groups.