Wednesday 11 December 2013

Progesterone supplementation in pregnancy

Progesterone is the main hormone in the second half of the menstrual cycle.
The levels of progesterone will be low in first half and starts to rise in the second half of the menstrual cycle.
They will increase studyly till 6 to 10 post ovulation.
And if fertilization do not occur the levels will decrease.
Values of progesterone before ovulation - < 1ng/ml
Values of progesterone in the middle of the cycle - 5 to 20ng/ml
 Ovary will produce the essential hormones for maintenance of menstrual cycle.
After ovulation, the ovarian follicle is called corpus luteum.
If a woman conceives in that menstrual cycle, then that is called corpus luteum of pregnancy.
Up to around 12 to 14 weeks, this corpus luteum of pregnancy will secrete the progesterone hormone, which is essential in pregnancy.
 Progesterone helps in preparing the endometrium to accept the zygote, that is implantation.
It also helps in maintaining the quiescence of the uterus, to prevent abortions, premature labor etc.
Normal levels of progesterone in first trimester of pregnancy - 11.2 to 90.0ng/ml
In second trimester of pregnancy - 25.6 to 89.4ng/ml
In third trimester of pregnancy - 48.4 to 42.5ng/ml
Usually corpus luteum of pregnancy and then placenta will produce the required progesterone in pregnancy.
But some women may have defective production of progesterone, that can lead to abortions, premature uterine action etc.
In these cases, supplementation of progesterone can help in preventing uterine action and in maintenance of pregnancy.
The duration of progesterone supplementation to be given depends on levels of progesterone in the woman, gestational age, previous gestational age at which abortion occurred etc.
In case of prior history of abortion, progesterone can be given two weeks more than previous gestational age when abortion occurred.
In case of anticipating preterm labor progesterone can be given upto 34 weeks of gestation.
Better to prefer natural micronized progesterone as per as possible.
Levels of progesterone will decrease after menopause to < 1ng/ml.
In males progesterone levels should be <1ng/ml.



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