Preterm birth is a condition that occurs when a baby is born before 37 weeks of pregnancy. Premature babies often have more health problems than full-term babies (born between 39 and 40 weeks of pregnancy). According to the results of many studies, Progestogen may help prevent premature birth for some women.
1. What is preterm birth?
Preterm birth is a condition that occurs when a baby is born before 37 weeks of pregnancy. About 70% of preterm births occur naturally, the remaining 30% of births can be due to medical decisions or as a result of maternal or fetal conditions (prenatal convulsions, placenta praevia, fetal growth retardation, …).
Preterm birth is the leading cause of neurological disability and infant death. Factors that increase the risk of preterm birth include: a history of previous preterm birth, vaginal bleeding, multiple pregnancy, low body mass index (BMI), genital tract infections, etc.
2. Progestogen’s effect in preventing premature birth
Progestogen is one of five types of steroid hormones. Progestogens are divided into 2 groups, exogenous group (progestin) and endogenous group (progesterone).
Progesterone is a hormone made by the body that plays an important role throughout pregnancy. In the early stages, progesterone helps the uterus grow and reduces contractility, which reduces the risk of miscarriage (because if uterine contractions occur in the early stages of pregnancy it can lead to miscarriage – a condition of pregnancy). intrauterine death before 20 weeks).
For the later part of pregnancy, progesterone helps the mammary gland develop to get ready for lactation and helps the lungs work better to provide more oxygen for fetal development. At the same time, progesterone also modulates immune responses by reducing the production of proinflammatory cytokines and smooth muscle relaxation, thereby blocking oxytocin activity and inhibiting the formation of uterine smooth muscle activation reactions. . In particular, progesterone also prevents the self-destruction of fetal membrane cells.
There are 2 types of progesterone:
Reduces the risk of premature birth in women who are single and have a short cervix. Short cervical means the length of the cervical canal is shorter than normal (<20mm), leading to the phenomenon of cervical opening earlier, before the fetus is ready to give birth. Your doctor may prescribe a woman using progesterone vaginal gel, capsule or capsule.
The advantage of vaginal progesterone is its high uterine bioavailability because of its effects on the uterus before its first metabolism in the liver. However, vaginal progesterone may also cause uncomfortable vaginal irritation, but less systemic side effects. And because vaginal progesterone has a half-life of about 13 hours, it is usually given daily, with a dose of 90 mg – 400 mg;
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Reducing the risk of preterm birth in the case of a single pregnancy with a history of preterm birth, this progesterone contains 17 alpha-hydroxyprogesterone caproate (also known as 17P). Doctors usually use progesterone by injection for pregnant women starting from 16-24 weeks and until 36 weeks of pregnancy. The vaccine is either Makena (a brand-name drug) or a blending compound (used for those who are allergic to the ingredients of Makena). When injecting the drug, pregnant women may have discomfort at the injection site.
Note: Progestogen therapy does not apply to multiple pregnancies, but to single pregnancies.
Preterm birth is a major cause of perinatal death and other conditions. Progestogen plays an important role in preventing spontaneous preterm birth in 2 groups of women: women with a history of preterm birth, single pregnancies and single pregnant women with a short cervix. When using Progestogen to prevent preterm birth, pregnant women need to follow the doctor’s instructions.