Micronized progesterone: a beneficial new modality of treatment for Egyptian patients with hyperemesis gravidarum
M. Aboul-Seoud, A. Shams El-Din, M. Elabd, A. Abdel-Rahman & M. Zaitoun
Aim: Progesterone is thought to be associated with hyperemesis gravidarum (HG). Pregnancies in which progesterone is administered for luteal phase support do not exhibit an increased incidence of HG, suggesting that high progesterone levels alone do not cause HG. The aim of the present study was to evaluate the therapeutic role of progesterone therapy as a new modality in the management of hyperemesis.
Subjects: In total, 40 Egyptian women below 40 years of age, pregnant 20 weeks with no preconception history of any other medical illnesses. They were randomly subdivided into: Group I: 20 patients managed by i.v. fluids and micronized progesterone 300400 mg vaginally/day for 2 weeks. Group II: 20 pregnant women who received the traditional lines of treatment of HG. A control group composed of 15 pregnant women.
Methods: Assessment of fasting serum progesterone and serum estradiol level was done. Transabdominal ultrasound examination was carried out to exclude vesicular mole and multiple pregnancies.
Results: Before treatment: the mean value of serum estradiol in patients treated with micronized progesterone was found to be not significantly different from that of patients treated conventionally. The mean serum progesterone values of patients treated with micronized progesterone was found to be not significantly different from that of patients treated conventionally or that of control subjects. Patients treated conventionally had a significantly higher E2/progesterone ratio than normal controls. After treatment: The E2/progesterone ratio was significantly lower in patients treated with micronized progesterone when compared to those patients treated conventionally, but it was still significantly higher than that of control subjects.
Conclusions: Serum levels of estradiol are significantly higher in hyperemetic patients compared to normal pregnant women. When balance is restored by increasing natural progesterone levels, these symptoms typically disappear. Therefore, micronized progesterone has a significant beneficial effect to treat Egyptian pregnant women suffering from HG.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.