There is no change in the level of progesterone in maternal
blood in the weeks before birth, but functional progesterone withdrawal occurs
immediately before birth (in preterm or term deliveries). For this reason,
progesterone is thought to be responsible for uterine relaxation during the
weeks of gestation and the onset of delivery afterwards.
Use of
progesterone to prevent preterm labor:
- In patients with no previous history of preterm labor and
unknown cervical length, progesterone is not recommended to prevent preterm
labor. There is not enough evidence to recommend it.
- (Routine cervical length assessment is not recommended in
the low-risk patient group during pregnancy.)
- Progesterone treatment is recommended for the purpose of
preventing preterm delivery in patients with no previous preterm labor history
and cervical length measured below 20 mm.
- In order to prevent preterm delivery in pregnancies with a
preterm delivery history, 250 mg hydroxyprogesterone (intramuscular) is
recommended once a week between 20-37 weeks of gestation.
- The use of progesterone is not recommended to prevent
preterm labor in twin-triplet pregnancies, its benefit has not been proven.
- Progesterone is not recommended for PPROM patients in order
to prevent preterm labor.
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