Does Progesterone Help To Prevent Preterm Labour?

Pre-term labour could lead to many complications during childbirth and after, where the baby will have to be incubated. While this is an undesirable situation, there are times when it is necessary as the baby is ready to pop out.

Preterm labour is when the baby arrives anywhere between the 28th and the 33rd week of pregnancy. They are at increased risk of infant mortality. Studies have shown that using progesterone can, however, reduce this risk by up to 40%. Progesterone injections for preterm labour are a common occurrence for many women before giving birth.

What is Progesterone?

Progesterone is a hormone that is released in females and it plays a major role in controlling menstruation after ovulation. In pregnant women, it can help prevent preterm birth by nullifying the contractions that lead to the same.

It is important that babies make it as close to their due date as possible because it could lead to a lot of complications in terms of health.

Role of Progesterone Hormone in Pregnancy

Progesterone supply during pregnancy is vital as it helps the endometrium strong to nurture the fetus in the body. It provides a supportive environment in different stages of the pregnancy to ensure that the fetus stays healthy throughout the entire time period.

As the pregnancy progresses, progesterone plays a role in helping the breasts get ready to produce milk for the baby. Also, the lungs are strengthened with the help of this hormone to provide more amounts of oxygen.

Post 8 to 10 weeks of the pregnancy period, the placenta takes over from the ovaries to increase the amount of progesterone for the prevention of preterm birth.

When do Doctors Recommend Progesterone Therapy to Pregnant Women?

Generally, women who are more likely to have miscarriages or preterm births are provided additional progesterone therapy. Here are a few situations where progesterone might be prescribed:

1. Past Preterm Births

When a mother has gone through the experience of a preterm birth in the past, doctors generally advise progesterone therapy. This therapy is generally started somewhere around the 16th to the 20th week of pregnancy and continues well into the 36th week.

The 17 hydroxyprogesterone for pre-term labour is injected into the mother, with a typical dosage anywhere around 250 mg.

2. Short Cervix

A short cervix can be insufficient to hold the fetus in for longer periods of time and this can lead to preterm birth. This can pose many risks for mothers and it is recommended that pregnant women get their cervix measured between the 19th and 24th week of pregnancy.

Physicians carefully monitor the cervical length, in cases of previous preterm births with ultrasounds done every two weeks – right from week 15 till week 24-26. There are also many risk factors for short cervix including:

• C and D procedures (surgeries that can scrape the lining of the uterus)
• Cervical incompetence in previous pregnancies
• Any situations of PPROM – Previous Preterm Premature Rupture of Membranes
• Any biopsy of the cervix used to remove pre-cancerous tumours or diagnostic purposes
• Previous childbirth trauma when the cervix got torn
• Later-term or even repeated abortion
• Abnormalities in the uterine and anomalies
• Diethylstilbestrol (DES) exposure

For those who have a shorter cervix, the progesterone is generally given at the 18th week of pregnancy and is continued right till the 36^th week. This type of therapy sessions involve the administration of the body’s natural progesterone in the following forms:

• Gels
• Vaginal suppository
• Tablets

3. Past PPROM

The Premature Rupture of Membranes occurs when the chorionic membranes and amniotic sac rupture even before the process of labour. When this happens before the 37^th week of pregnancy, the condition is called PPROM (Preterm PROM). In such cases, providing progesterone is not as effective for those having the PPROM in their first pregnancy, but they will benefit in subsequent pregnancies.

4. Other conditions

Progression in the field of medicine can lead to additional uses for progesterone for the prevention of preterm delivery. Some have suggested progesterone therapy can help those women who have experienced premature labour in their current pregnancy though the validity of this is still not fully clear.

Progesterone Treatment during Pregnancy

There are different ways to administer progesterone treatments during pregnancy, depending on the doctor’s advice. If you’re someone who’s in line for progesterone treatment, then you could be prescribed shots, suppositories and tablets based on what’s best for you.

1. Progesterone Shots

Progesterone shots for preterm labour is a common way of getting the hormone into pregnant women. It involves an oil-based solution being injected into the body and this is also the most established way of providing progesterone to pregnant women.

The injection is inserted into the buttocks once a day and it uses thick or larger needles to penetrate thick skin and fat. This method cannot be done by patients on their own and they will require medical intervention as the process can sometimes be painful to endure.

The Progesterone shots to prevent preterm labour side effects include skin reactions and rashes but these are common and should be expected.

2. Vaginal Progesterone

The vaginal progesterone delivery method includes vaginal gels, vaginal inserts. An FDA approved vaginal gel is used once a day for up to 12 weeks of pregnancy. A majority of women who have used this gel have approved its convenience and the comfort that it provides.

There are also progesterone oral tablets that are used vaginally in addition to inserts that are effective for women under 35 years.

Progesterone Suppositories

These suppositories are generally compounded at pharmacists and are wax-based. These can be used two to three times a day though they can cause a messy leakage in the process.

What Are Its Side Effects?

Progesterone shots and oral medicines can give rise to various side effects in women, which are minor. However, if a pregnant woman has liver disease or arterial disease, then the progesterone is contradicted.

Some of the side effects include:

• Vaginal discharge after shots
• Irritation or reactions at the site of injection
• Fatigue
• A headache
• Sleepiness
• Nausea

The last four side effects are consistent with oral medications.

Natural Ways To Avoid Preterm Birth

There are a few natural ways to prevent preterm birth. These include:

• Following a healthy diet
• Visiting the doctor regularly
• Take care of any health problems – like diabetes, high BP and depression
• Have a diet that incorporates different food and stay healthy.

Thus, progesterone is known to help improve the health of the cervix and ensure a healthy pregnancy. Consult a doctor before proceeding and using the same, to avoid any side effects

Also Read: Taking Progesterone to Prevent Miscarriage