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Licensed Unlicensed Requires Authentication Published by De Gruyter September 23, 2016

Progesterone in normal and pathological pregnancy

  • Gian Carlo Di Renzo EMAIL logo , Irene Giardina , Graziano Clerici , Eleonora Brillo and Sandro Gerli

Abstract

Progesterone is an essential hormone in the process of reproduction. It is involved in the menstrual cycle, implantation and is essential for pregnancy maintenance. It has been proposed and extensively used in the treatment of different gynecological pathologies as well as in assisted reproductive technologies and in the maintenance of pregnancy. Called “the pregnancy hormone”, natural progesterone is essential before pregnancy and has a crucial role in its maintenance based on different mechanisms such as: modulation of maternal immune response and suppression of inflammatory response (the presence of progesterone and its interaction with progesterone receptors at the decidua level appears to play a major role in the maternal defense strategy), reduction of uterine contractility (adequate progesterone concentrations in myometrium are able to counteract prostaglandin stimulatory activity as well as oxytocin), improvement of utero-placental circulation and luteal phase support (it has been demonstrated that progesterone may promote the invasion of extravillous trophoblasts to the decidua by inhibiting apoptosis of extravillous trophoblasts). Once the therapeutic need of progesterone is established, the key factor is the decision of the best route to administer the hormone and the optimal dosage determination. Progesterone can be administered by many different routes, but the most utilized are oral, the vaginal and intramuscular administration. The main uses of progesterone are represented by: threatened miscarriage, recurrent miscarriage and preterm birth (in the prevention strategy, as a tocolytic agent and also in the maintenance of uterine quiescence).


Corresponding author: Gian Carlo Di Renzo, MD, PhD, FRCOG (hon), FACOG (hon), FICOG (hon), Professor and Chairman, Department of Obstetrics and Gynaecology, Centre for Perinatal and Reproductive Medicine, Santa Maria della Misericordia University Hospital, 06132 San Sisto, Perugia, Italy, Phone: +39 075 5783829, +39 075 5783231, Fax: +39 075 5783829

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Received: 2016-7-21
Accepted: 2016-8-4
Published Online: 2016-9-23
Published in Print: 2016-7-1

©2016 Walter de Gruyter GmbH, Berlin/Boston

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