Any Pregnancy proceeds individually. In spite of the extensive medical knowledge, this pleasant event sometimes ends regrettably much earlier than desired. The child is then born too early, but viable, or the woman suffers a miscarriage (abortion). This puts an enormous strain on the women concerned and the couple relationship. In particular, repeated miscarriages, so-called habitual miscarriages, increase the risk that the next pregnancy will end in another miscarriage. On the other hand, there are recognized risk factors for preterm birth, the knowledge of which enables countermeasures to be taken. Read here in which cases Progesterone can help.
To prevent a premature birth, the use of progesterone can be useful.
When is a premature birth?
One speaks of Preterm birth, if the baby is born before 37. The first week of pregnancy (SSW) 1 . Medical advances mean that smaller and more immature babies are increasingly surviving past 23. until 24. Week of pregnancy. These extreme premature babies usually have to deal with lifelong impairments. For example, many of these children develop delayed. In addition, it is possible that hearing or vision is impaired. In some cases, even severe brain damage is possible.
In 2017, 8% of babies in Germany were born prematurely 1 . However, this also means that the vast majority of babies remain in their mother’s womb long enough to be optimally prepared for the start of their own lives.
Which factors increase the risk of premature birth?
The Risk The risk of premature birth, for example, is increased in the case of
- shortened cervix (neck of the womb),
- high blood pressure and
- Multiple pregnancies.
Premature labor with or without rupture of the membranes is the cause in about two-thirds of all preterm births.
Progesterone in case of prematurely shortened cervix and threatened premature birth
Typically, the cervix shortens toward the end of pregnancy to prepare for delivery. Is the Cervix but prematurely shortened, i.e. shorter than 25 mm before 24 weeks of gestation. If the baby is born before the second week of gestation, the risk of premature birth increases. Because this shortening causes the cervix to open too early during pregnancy. German-speaking gynecological societies then recommend a Progesterone substitution. That is, women supply the body with progesterone. Progesterone is available, for example, as a capsule or gel, which is administered vaginally.
In special cases, drugs are temporarily used to inhibit premature labor (tocolysis) 1 . Currently there is no recommendation on whether additional progesterone is then also useful 1 .
Multiple pregnancies occur more frequently with fertility treatments, they are considered high-risk pregnancies. If there are identifiable risk factors, such as a shortened cervix, vaginal administration of progesterone is recommended.
Progesterone in multiple pregnancies
Multiple pregnancies are generally considered high-risk pregnancies. For example, the premature birth rate in the case of Twin pregnancies at about 60 % 1 . Nevertheless, not every pregnant woman expecting twins receives prophylactic medication directly. There is a lack of scientific data on this so far. For women with a twin pregnancy and a prematurely shortened cervix, the vaginal administration of progesterone, however, recommended 1 .
Multiple pregnancies also often occur as a result of fertility treatment. Because two, sometimes even three fertilized eggs are frequently transferred into the woman’s uterus. According to Infertility treatment progesterone supplementation to support the luteal phase and early pregnancy is generally given until 12 weeks of gestation in many treatment centers. SSW.
How common are miscarriages?
It is assumed that up to 50% of all pregnancies end in miscarriage. However, many miscarriages are not perceived as such because they occur spontaneously, completely unnoticed, during the first two to three weeks of pregnancy. The woman often does not know that she is pregnant and perceives the bleeding as a delayed period. This is referred to as Early abortion, if the miscarriage occurs within the first 12 to 14 weeks of gestation. If a woman has three or more spontaneous miscarriages before 12 weeks of gestation, the baby will be born. If a baby is born too early after the first week of gestation, it is a so-called "premature pregnancy Habitual abortions. About 1 to 3% of all couples are affected 2 . As a result of these, the risk of the next pregnancy ending in miscarriage again increases.
There are several ways to support and maintain a pregnancy. However, they do not help to prevent miscarriage in every pregnancy or in every woman. The first step to Abortion prevention is to clarify the possible causes. These are treated specifically, if possible.
Causes of miscarriages
The causes of miscarriage are unfortunately very diverse. Diseases of the mother include infections, anemia or hormonal disorders. Furthermore, genetic causes or malformations of the child are reasons for miscarriage. An increased Risk of miscarriage Women with endometriosis or changes in the uterus and placenta are also at risk of miscarriage. In addition, there are many individual causes that can influence a miscarriage, such as drug abuse. Among the numerous causes of habitual premature abortion, luteal phase insufficiency is also discussed. The resulting progesterone deficiency is probably involved in the embryo’s failure to develop and in miscarriage.
Is abortion prophylaxis with progesterone possible??
In some women, the administration of progesterone can help prevent a miscarriage. Research proves: Natural progesterone administered vaginally improves nutrient delivery to embryo 3 . Therefore, the prophylactic administration of progesterone in women with habitual abortions a treatment option. Especially in women with four or more previous miscarriages, the use of Progesterone be considered 4 . A study also shows that progesterone increases the rate of live births in women with vaginal bleeding and at least one previous miscarriage 5 . This means that more of these women will end up having a baby if they work until they are 16. Take progesterone during the first SSW. However, progesterone does not help in all cases of. This means that a miscarriage can occur despite taking progesterone.
Some women reproach themselves that a Abortion or a Preterm birth miscarriage, perhaps because they have not taken enough care of themselves. However, it is not sufficiently clear whether physical rest, work reduction or even bed rest prevent an abortion or premature birth. Recommendations for this are therefore only made in justified individual cases. One thing is certain: Too much lying increases the thrombosis risk of the expectant mother and favors muscle degradation and osteoporosis.