Progesterone and miscarriage risk: everything you need to know

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Progesterone and miscarriage risk

Progesterone is a female sex hormone belonging to the steroid group. It is often first heard of during pregnancy.

Ovules, tablets taken from the first weeks of pregnancy, placental abruption, pain in the lower abdomen: there are several stories that interest mothers-to-be when it comes to progesterone.

But commonly this hormone is associated with the danger of miscarriage. Its intake, in fact, in most cases, serves precisely to avoid or prevent the death of the fetus. 

In fact, progesterone is not only essential to prepare the uterus for pregnancy, but also to protect it after the embryo is implanted and for all 9 months. 

In this article

  • The benefits of progesterone in pregnancy
  • Progesterone against abortion threats
  • Miscarriage and progesterone intake: what scholars say
  • Spontaneous abortion even if you take progesterone: why it happens



Read also: Oxytocin and childbirth: what it is for, risks and when to administer it

The benefits of progesterone in pregnancy

The role of progesterone in pregnancy is crucial, as mentioned above. This hormone, which the body produces naturally but sometimes requires an increment in the form of oral tablets or vaginal pessaries, ensures that the fetus receives the nutrients it needs to grow. 

Here, in summary, are all the functions of progesterone in pregnancy:

  • increases blood flow to the uterus
  • stimulates the mucous membrane of the endometrium to produce nutrients for the embryo
  • stimulates the growth of maternal breast tissue
  • controls the regular growth of the fetus
  • prevents breastfeeding before childbirth
  • prevents contractions and premature birth
  • strengthen the pelvic wall muscles in preparation for labor

A drop in progesterone during pregnancy can also lead to miscarriage and early labor. This is why it should be monitored by the gynecologist. 

Progesterone against abortion threats

Usually a miscarriage is preceded by some symptoms. The most common are bleeding and cramps in the lower abdomen. Sometimes, unfortunately, spontaneous abortion occurs without the mother noticing it, many other times, however, a spontaneous abortion can be averted with rest and adequate therapies. These also include the intake of progesterone.

Faced with vaginal bleeding, uterine contractions and all those symptoms that synthetically fall within the so-called "abortion threats", the gynecologist does not wait but prescribes a therapy based on ovules and progesterone tablets. rest. 

Il progesterone in pregnancy it is taken in the form of vaginal suppositories, vaginal creams, oral tablets or intramuscular injections. Its regular intake has the task of supporting pregnancy by relaxing the uterus and promoting correct implantation. Progesterone can also be combined with antispasmodics or decontracting agents, with the task of blocking uterine contractions. The woman must also avoid exertion and refrain from sexual intercourse. 

Miscarriage and progesterone intake: what scholars say

Over time, many studies have been carried out on progesterone and its usefulness in pregnancy to avert the risk of spontaneous abortion. In particular, in January 2022 some researches carried out by researchers from the National Center for Research on Miscarriage of Tommy and the University of Birmingham were published and highlighted its importance.

According to the experts taking progesterone could prevent 8.450 miscarriages per year. Research has highlighted the benefits of administering progesterone to women with premature bleeding or a history of miscarriages.

The first of the new studies, published today in the American Journal of Obstetrics and Gynecology, examines the results of 2 major clinical studies - PROMISE e PRISM - conducted by the University of Birmingham and Tommy's National Center for Miscarriage Research and funded by the National Institute for Health Research (NIHR). In detail, PROMISE studied 836 women with unexplained recurrent miscarriages in 45 hospitals in the UK and the Netherlands and found a 3% higher live birth rate with progesterone, but with substantial statistical uncertainty. PRISM, on the other hand, studied 4.153 pregnant women with early bleeding in 48 hospitals in the UK and found a 5% increase in the number of babies born to those who were given progesterone. The benefit found was even greater for women who had had previous recurrent miscarriages with a 15% increase in the birth rate in the progesterone group compared to the placebo group.

Spontaneous abortion even if you take progesterone: why does it happen?

Although its importance has been proven by scholars, it must be said that - unfortunately - progesterone cannot be the absolute solution. There are cases in which spontaneous abortion occurs before a progesterone-based therapy can be started and others in which administration (oral, vaginal or intravenous) is not sufficient and abortion occurs equally

In fact, most spontaneous abortions are caused by a genetic or chromosomal abnormality of the fetus. Non-genetic causes, on the other hand, include maternal hormonal disorders (such as diabetes or thyroid dysfunction), uterine pathologies (malformations, fibroids), severe trauma and infectious diseases, those of the immune system or coagulation.

Fonte: Tommy's Research

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