As per WHO, India leads with the highest number of preterm births, with more than 60% of preterm births occurring in Africa and South Asia. India accounts for a whopping 25% contribution of the overall global preterm related deaths. Yes, we admit this is a worrisome result. Here comes another fact that will help to relieve your worry to some extent. By recognizing the symptoms and taking some preventive measures at the right time, 40% to 50% of the pregnancies that bear the risk of preterm delivery can be carried till the 38th week of gestation successfully. Progesterone treatment is one of the methods used to prevent the preterm labor among the expecting mothers who bear the risk of preterm labor.
progesterone treatment

What Is Progesterone?

Progesterone is a hormone that is normally created by the female body that involves in menstrual cycle and pregnancy. It starts to release as early as 12 to the 15th day of the pregnancy that is more or less before you even know you are pregnant. Though during the early days of pregnancy it is released from a part of the egg follicle, once the pregnancy reaches the 10th week of gestation, the placenta will take the control and starts to produce the progesterone. An optimum level of progesterone is required for the progression of a healthy pregnancy.

What Is The Role Of Progesterone During Pregnancy?

Progesterone plays a significant role in the course of pregnancy. During the early stages, this hormone has a vital role in the growth of the uterus and in preventing the contractions. If it were not there, contractions during the early stages of pregnancy can cause a miscarriage. During the later stages of pregnancy, it plays an important role in getting the breasts ready to produce milk for the baby. Progesterone also helps your lungs work more efficiently and better to provide adequate oxygen to the baby. Its level will become considerably low towards the end of the gestation, as the uterus has to undergo contractions to give birth.

What Is Progesterone Treatment?

Progesterone treatment is suggested for women bearing a single baby and at the risk of the preterm delivery. Since babies born before 37 weeks of pregnancy can have health issues and need to be closely monitored, doctors around the world suggest the treatment to reduce the chances of the same. There are two types of progesterone treatment:

  1. Vaginal progesterone: This treatment is suggested for the mothers who are at risk of preterm birth and experience an issue of short cervix. The short cervix is a condition in which the length of the cervix, the opening of the uterus, is very short than the normal length. This increases the risk of preterm birth as it opens earlier when compared to the cervix with the normal length. In such cases, vaginal progesterone treatment will help to keep the chances of preterm labor at bay.
    In this treatment, progesterone is deposited inside the vagina. It comes in three forms:

    1. Gel
    2. Capsule
    3. Suppository

    This treatment usually starts on or before the 24th week of pregnancy and continues until the 37th week. This treatment has a practical side on the grounds that vaginal progesterone is less costly and is an option that is less invasive when compare to the cerclage (putting cervical suture) another option for the expecting mothers with a short cervix. No significant side effects are detected until now

  2. Progesterone shots: This is another type of progesterone treatment. The doctor suggests this if the expecting mother has a history of experiencing spontaneous preterm delivery (with one child). Spontaneous delivery refers to the delivery that takes place on its own without undergoing any method of inducing the labor.
    The shots are given between 16th to 24th weeks of pregnancy, depending on the cause of the previous spontaneous preterm delivery. It is a weekly shot and will continue until the 37th week of gestation. Makena, in which the synthetic progesterone is in the form of hydroxyl progesterone, is the most widely used progesterone shots. Nevertheless, in the event that, the mother develops an allergy to any of the ingredients of this brand, a prepared or compounded version of progesterone shots are also available in some special pharmacies

Preterm birth and progesterone

What Is A Short Cervix?

The opening to your womb or the uterus is known as the cervix. Sitting on the top of vagina, during labor and birth it opens, gets thinner and softens to allow the baby to pass through the birth canal. A short cervix presents the risk to open too early, leading to a premature delivery, that is before the baby is ready to be born. This condition is known as cervical insufficiency or incompetent cervix and makes you run for a 50% chance for a premature birth. A short cervix can be detected through an ultrasound, and in case you are diagnosed with one, you doctor may offer you progesterone treatment to reduce the chances of having an early delivery. Remember, this works only if you are carrying a single baby.

Does Progesterone Treatment Work For Multiple Pregnancies?

No. For some reason, the progesterone treatment, irrespective of whether the vaginal deposition, or shots, have no significant effect if the mother is bearing more than one child. This is applicable for the fetuses who share the same placenta or develop separate placentas. More research is required in this field to find out the reason and the remedy.

Is It Safe To Take Progesterone Treatment?

Several follow-up studies are conducted to monitor the baby (until they turn 4 years) of the mother who undergone progesterone treatment in the course of pregnancy. No developmental issues or birth defects are detected as a result of progesterone treatment. However, minor side effects like headaches, fatigue, constipation, breast tenderness, discomfort in the injected area, etc. are found among the mothers while undergoing the treatment.